Long-acting benzodiazepines among the top predictors of Potentially
Inappropriate Psychotropic (PIP) Medication
Abstract
Background: There is limited information available on the use of PIP
medication in older adults having psychiatric illness. Objective: To
determine the prevalence of PIP medications, and assess its predictors
in older adults with psychiatric illness. Methods: A cross-sectional
study was carried out at a tertiary care hospital on 456 patients of
either sex, with a median age of 65 years attending the psychiatry
outpatient department. Evaluation of PIP medication was done using Beers
criteria 2019 and STOPP criteria 2015. Bivariate logistic regression was
used to find out the predictors of PIP prescribing. Results: Results of
the study reflect that a staggering number of older adults, (more than
91% and 73%) out of total of 456 patients were prescribed with at
least one PIP medication identified by Beers criteria and STOPP
criteria, respectively. Long-acting benzodiazepine (LABZD) like
clonazepam was identified as one of the most commonly prescribed PIP
medications by both set of criteria. Further analysis revealed that
older adults from rural background (Odds Ratio (OR) 2.60, 95%
Confidence Interval (CI) 1.20-5.65; P=0.015), TCA (OR 0.30, 95% CI
0.12- 0.75; P= 0.010), LABZD (OR 33.72, 95% CI 11.27-100.85;
P=<0.001), atypical antipsychotics (OR 22.35, 95% CI 5.31-
93.99; P= <0.001) use were most common predictors for PIP
medication prescribing. Conclusion: The use of PIP medication is highly
prevalent among older adults according to Beers criteria and STOPP
criteria. The study reflects a more comprehensive and sturdy nature of
Beer criteria as it significantly detects more PIP medication than STOPP
criteria.