Geographic variation in psychotropic drug utilisation among older people in New Zealand

Australas J Ageing. 2016 Dec;35(4):242-248. doi: 10.1111/ajag.12298. Epub 2016 Mar 15.

Abstract

Aim: To examine psychotropic drug utilisation in older people in New Zealand by age, sex, health board domicile and deprivation status.

Methods: A repeated cross-sectional analysis of population-based drug utilisation data stratified by age, sex, ethnicity, health board and deprivation status was conducted from 2005 to 2013.

Results: Psychotropic utilisation increased between 2005 and 2013 (ranging from 7.0 to 74.0%) across all the health boards. In people aged 85 years and above, the hypnotic and sedative prevalence ratio compared to the 65- to 69-year age group was 1.45 (95% CI 1.44, 1.46). Between 2005 and 2013, the antidepressants prevalence ratio increased (1.27 (95% CI 1.22, 1.33)) relative to anxiolytics.

Conclusions: Overall psychotropic drug utilisation increased over time. Despite safety concerns, hypnotic and sedative utilisation increased in the oldest vulnerable group. Shifts from anxiolytics to antidepressants in some health boards were consistent with guidelines for extended indications of antidepressant drug use.

Keywords: defined daily dose; older people; prevalence ratio; psychotropic drug; variation.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Anti-Anxiety Agents / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Catchment Area, Health*
  • Cross-Sectional Studies
  • Cultural Deprivation
  • Drug Utilization Review / trends
  • Female
  • Health Care Surveys
  • Healthcare Disparities / trends*
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Male
  • New Zealand
  • Poverty / trends
  • Practice Patterns, Physicians' / trends*
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / therapeutic use*
  • Residence Characteristics*
  • Sex Distribution
  • Time Factors

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Hypnotics and Sedatives
  • Psychotropic Drugs