Co-prescriptions of psychotropic drugs to older patients in a general hospital

Introduction: The prescription of psychotropic drugs to older patients in a hospital setting has not been extensively characterized. The objective was to describe the inappropriate co-prescriptions of psychotropic drugs in hospitalized patients aged 75 and over. Methods: By analysing the medical database from 222-bed general hospital in France, we reviewed a total of 11,929 stays of at least 3 days by patients aged 75 and over. Prescriptions and co-prescriptions of psychotropic drugs were identified automatically. Anticholinergic drugs with sedative effects were considered as psychotropic drugs. An expert review was performed for stays with the co-prescription of three or more psychotropic drugs to identify inappropriate co-prescriptions. Results: Administration of a psychotropic drug was identified in 5475 stays (45.9% of the total number of stays), of which 1526 (12.8% of the total) featured at least one co-prescription. Co-prescriptions of three or more psychotropic drugs for at least 3 days were identified in 374 stays (3.1% of the total). Most of these co-prescriptions (n = 334; 89.2%) were considered inappropriate because of the combination of at least two drugs from the same psychotropic class (n = 269), the absence of a clear indication for a psychotropic drug (n = 173) and a history of falls (n = 86). However, the co-prescriptions were maintained after hospital discharge in 77.4% of cases. Conclusion: The co-prescriptions of psychotropic drugs should be re-evaluated in older hospitalized patients. (C) 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.