Psychotropic drug use among older people in general practice: discrepancies between opinion and practice

Publié le 1 Avril 2010
Mis à jour le 5 juillet 2019

Background: The use of psychotropic drugs has increased over recent years in France. GPs are the first prescribers, especially for older patients. Aim: To analyse discrepancies between GPs" opinions and practice when prescribing psychotropic drugs to older patients. Setting: Postal surveys sent to GPs all over mainland France. Design of study: Cross-sectional postal study. Method: A questionnaire collected data on characteristics of GPs" practices, their opinions about psychotropic drug consumption in older people, and a full description of their last older patient receiving a psychotropic drug and seen last by the GP on that particular day. Results: A total of 350 participating GPs saw 2498 patients aged > or =65 years. Among these patients, the prevalence of psychotropic use was 32.1% (803/2498) for anxiolytics/hypnotics, and 17.5% for antidepressants (438/2498). A total of 91% of GPs agreed that it was possible to reduce or stop psychotropic drugs for these patients. Characteristics of 339 patients taking psychotropic drug were reported: 85.8% (291/339) received at least one anxiolytic/hypnotic and 56.9% (193/339) received at least one antidepressant; there were prescribed for more than 1 year in 68.4% (199/291) and 43.5% (84/193) of the cases respectively. GPs stated that it was possible to reduce or stop anxiolytic/hypnotic drugs for only 27% (79/291) of these patients. Barriers to doing this were patients" refusal (79%), and the absence of any local offer of psychotherapy (73%) or alternative therapy (70%). Conclusion: A mismatch exists between GPs" intent (91%) and practice (27%) regarding reduction of psychotropic prescription in individuals aged > or =65 years. The barriers encountered should be examined further to help physicians improve management of psychotropic prescription.

Auteur : Lasserre A, Younes N, Blanchon T, Cantegreil Kallen I, Passerieux C, Thomas G, Chan Chee C, Hanslik T
British Journal of General Practice, 2010, vol. 60, n°. 573, p. e156-62