Social differences associated with the use of psychotropic drugs among men and women aged 65 to 74 years living in the community: the international mobility in aging study (IMIAS)

BMC Geriatrics

Maria Victoria Zunzunegui²  Jack Guralnik³  Alban Ylli¹  Fernando Gomez⁴  Boukaré Doulougou²  Gustave Noufou Nana² 

[1] National Institute of Public Health, Tirana, Albania;Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada;Department of Epidemiology and Public Health, Division of Gerontology, School of Medicine, University of Maryland, Baltimore, MD, USA;Research group on gerontology and geriatrics, University of Caldas, Manizales, Colombia

关键词: Albania;    Canada;    Latin America;    Social differences;    Aging;    Psychotropic drugs;   

Others  :  1220006
DOI  :  10.1186/s12877-015-0083-3

 received in 2015-02-10, accepted in 2015-07-06,  发布年份 2015

【 摘 要 】

Background

Elderly persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications. The aim of this study is to examine social differences in the use of psychotropic drugs among persons aged 65–74 years in the International Mobility in Aging Study (IMIAS).

Methods

The sample consisted of 1,995 participants in the IMIAS 2012 baseline study in Saint-Hyacinthe (Canada), Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). During home visits, all medication taken by the participants in the previous 15 days was recorded. We then used the Anatomical Therapeutic Chemical classification system to code psychotropic drugs as anxiolytics, sedatives, hypnotics (ASH); antidepressants (ADP); or analgesics, antiepileptics, or antiparkinsonians (AEP). Prevalence ratios for psychotropic drug use according to sex, education, income, and occupation were estimated by fitting a Poisson regression and controlling for demographic and health covariates.

Results

Psychotropic drug use was higher among Canadian participants than among those living outside Canada. Prevalence of AEP drug use was higher for women than men in the Canadian and Latin American sites. In Tirana, antidepressant drugs were rarely used. Socioeconomic differences varied among sites. In the Canadian cities, low socioeconomic standing was associated with higher frequency of psychotropic drug use. In the Latin American cities, elderly people with high education and income levels showed a higher level of antidepressant drug use, while people with manual occupations had a higher use of AEP drugs. In Tirana, ASH drug use was higher among those with low income.

Conclusion

An inverse association was observed between socioeconomic standing and psychotropic drug use in Canada, while the opposite was true in Latin America. Albania was notable for an absence of antidepressant use and greater use of ASH drugs among low-income groups.

【 授权许可】

   
2015 Nana et al.

【 参考文献 】

• [1]Blumstein T, Benyamini Y, Chetrit A, Mizrahi EH, Lerner-Geva L: Prevalence and correlates of psychotropic medication use among older adults in Israel: cross-sectional and longitudinal findings from two cohorts a decade apart. Aging Ment Health 2012, 16(5):636-47.
• [2]Zhang Y, Chow V, Vitry AI, Ryan P, Roughead EE, Caughey GE, et al.: Antidepressant use and depressive symptomatology among older people from the Australian longitudinal Study of Ageing. Int Psychogeriatr 2010, 22(2):437-44.
• [3]Mojtabai R, Olfson M: Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff (Millwood) 2011, 30(8):1434-42.
• [4]Noordam R, Aarts N, Verhamme KM, Sturkenboom MC, Stricker BH, Visser LE: Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: a dynamic population-based study. Eur J Clin Pharmacol 2015, 71(3):369-75.
• [5]Lader M: Long-term anxiolytic therapy: the issue of drug withdrawal. J Clin Psychiatry 1987, 48(Suppl):12-6.
• [6]Lai HY, Hwang SJ, Chen YC, Chen TJ, Lin MH, Chen LK: Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program. Clin Ther 2009, 31(8):1859-70.
• [7]Akazawa M, Imai H, Igarashi A, Tsutani K: Potentially inappropriate medication use in elderly Japanese patients. Am J Geriatr Pharmacother 2010, 8(2):146-60.
• [8]Ambresin G, Palmer V, Densley K, Dowrick C, Gilchrist G, Gunn JM: What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study. J Affect Disord 2015, 176:125-32.
• [9]Allard J, Allaire D, Leclerc G, Langlois SP: The influence of family and social relationships on the consumption of psychotropic drugs by the elderly. Arch Gerontol Geriatr 1995, 20(2):193-204.
• [10]Bossé C: Caracterisation de la consommation d'antidepresseurs chez les personnes âgées vivant à domicile. In Université de Sherbrook. Université de Sherbrook, Sherbrook; 2012.
• [11]Dealberto MJ, Seeman T, McAvay GJ, Berkman L: Factors related to current and subsequent psychotropic drug use in an elderly cohort. J Clin Epidemiol 1997, 50(3):357-64.
• [12]Rubio-Valera M, Fernandez A, Luciano JV, Hughes CM, Pinto-Meza A, Moreno-Kustner B, et al.: Psychotropic prescribing in Catalonia: results from an epidemiological study. Fam Pract 2012, 29(2):154-62.
• [13]Gustafsson T, Isacson D, Thorslund M, Sorbom D: Factors associated with psychotropic drug use among the elderly living at home. J Applied Gerontol 1996, 15(2):238-54.
• [14]Wastesson JW, Fastbom J, Ringback Weitoft G, Fors S, Johnell K: Socioeconomic inequalities in access to specialized psychotropic prescribing among older Swedes: a register-based study. Eur J Public Health 2014, 24(6):991-6.
• [15]Paige E, Korda RJ, Kemp A, Rodgers B, Banks E: Characteristics of antidepressant medication users in a cohort of mid-age and older Australians. Aust N Z J Psychiatry 2015, 49(3):275-90.
• [16]Sousa AC, Guerra RO, Thanh Tu M, Phillips SP, Guralnik JM, Zunzunegui MV: Lifecourse adversity and physical performance across countries among men and women aged 65–74. PLoS One 2014., 9(8) Article ID e102299
• [17]De Yebenes JG, Sanchez M, Mena MA: Neurotrophic factors for the investigation and treatment of movement disorders. Neurotox Res 2003, 5(1–2):119-38.
• [18]WHO Collaborating Centre for Drug Statistics Methodology. Anatomic Therapeutic Chemical / Defined Daily Dose Index 2015. Oslo: 2015. Available at: http://www.whocc.no/atc_ddd_index/. Accessed 15 January, 2015.
• [19]Government of Canada. People serving people: Old age security payment amounts. Ottawa: Government of Canada; 2015. Available at: http://www.servicecanada.gc.ca/eng/services/pensions/oas/payments/index.shtml?utm_source=vanity+URL&utm_medium=print+publication,+ISPB-185,+ISPB-341&utm_term=/oasamounts&utm_content=Mar+2013,+eng&utm_campaign=OAS+Pension+2013,+Benefits+for+Low+Income+Seniors Accessed June 02, 2015.
• [20]ILO. International Standard Classification of Occupations (ISCO-08). International Labour Office, Geneva 2012; 1:http://www.ilo.org/public/english/bureau/stat/isco/isco08/.
• [21]Radloff LS: The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1977, 1:385-401.
• [22]Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 2003, 3:21. BioMed Central Full Text
• [23]Petrea I, Haggenburg M: Chapter 10: Mental health care. In Trends in health systems in the former Soviet countries. Edited by Rechel B, Richardson E, McKee M. WHO, Copenhagen; 2014:159-72.
• [24]Petrea I: Mental health in former Soviet countries: From past legacies to modern practices. Public Health Rev 2013, 34:2.
• [25]World Health Organization. Mental health atlas-2011 country profiles : Albania. WHO: WHO; 2011. Available at: http://www.who.int/mental_health/evidence/atlas/profiles/alb_mh_profile.pdf?ua=1. Accessed June 9, 2015
• [26]Kakariqi L: Konsumi i barnave te rimbursueshem ne Shqiperi. Marin Barleti, Tirana; 2014.
• [27]Richardson E, Sautenkova N, Bolokhovets G: Chapter 9: Pharmaceutical care. In Trends in health systems in the former Soviet countries. Edited by Rechel B, Richardson E, McKee M. WHO, Copenhagen; 2014:145-58.
• [28]Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E: Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambui Health and Aging Study (BHAS). Rev Bras Psiquiatr 2008, 30(1):7-11.
• [29]Bierman AS, Pugh MJ, Dhalla I, Amuan M, Fincke BG, Rosen A, Berlowitz DR: Sex differences in inappropriate prescribing among elderly veterans. Am J Geriatr Pharmacother 2007, 5(2):147-61.
• [30]Huang B, Bachmann KA, He X, Chen R, McAllister JS, Wang T: Inappropriate prescriptions for the aging population of the United States: an analysis of the national ambulatory medical care survey, 1997. Pharmacoepidemiol Drug Saf 2002, 11(2):127-34.
• [31]Blumstein T, Benyamini Y, Shmotkin D, Lerner-Geva L: Gender differences in the prevalence and correlates of psychotropic medication use among older adults in Israel. Isr J Psychiatry Relat Sci 2014, 51(2):118-25.
• [32]Hohmann AA: Gender bias in psychotropic drug prescribing in primary care. Med Care 1989, 27(5):478-90.
• [33]Lane CJ, Bronskill SE, Sykora K, Dhalla IA, Anderson GM, Mamdani MM, et al.: Potentially inappropriate prescribing in Ontario community-dwelling older adults and nursing home residents. J Am Geriatr Soc 2004, 52(6):861-6.
• [34]Swami V: Mental health literacy of depression: gender differences and attitudinal antecedents in a representative British sample. PLoS One 2012., 7(11) Article ID e49779
• [35]van der Waals FW, Mohrs J, Foets M: Sex differences among recipients of benzodiazepines in Dutch general practice. BMJ 1993, 307(6900):363-6.
• [36]Addis ME, Mahalik JR: Men, masculinity, and the contexts of help seeking. Am Psychol 2003, 58(1):5-14.
• [37]Galdas PM, Cheater F, Marshall P: Men and health help-seeking behaviour: literature review. J Adv Nurs 2005, 49(6):616-23.
• [38]McVittie C, Willock J: "You can't fight windmills": how older men do health, ill health, and masculinities. Qual. Health Res 2006, 16(6):788-801.
• [39]Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E: A population based study on health conditions associated with the use of benzodiazepines among older adults (The Bambui Health and Aging Study). Cad Saude Publica 2009, 25(3):605-12.
• [40]Lynch JW, Kaplan GA: Socioeconomic factors. In Social Epidemiology. Edited by Berkman LF, Kavachi I. Oxford University Press, New York; 2000:13-35.
• [41]Grundy E, Holt G: The socioeconomic status of older adults: how should we measure it in studies of health inequalities? J Epidemiol Community Health 2001, 55(12):895-904.