Effect of age on the profile of psychotropic users: results from the 2010 National Ambulatory Medical Care Survey

Abstract

Objectives: To describe the effect of age on psychotropic coprescribing, psychiatric diagnoses, and other clinical characteristics.

Design: Analysis of the National Ambulatory Medical Care Survey.

Setting: A national sample of outpatient visits to physicians (N = 2,406) in office-based practice in 2010.

Participants: Adults prescribed psychotropic medication (N = 31,229).

Measurements: Office visits at which antidepressant, anxiolytic, sedative, hypnotic, antipsychotic, or mood stabilizer medications were prescribed were grouped according to participant age (21-64, ≥ 65) and then compared within each medication class on visit characteristics. and then compared according to variables including provider type, sex, and race; presence of diagnosed mental illness; prescription of other psychotropic agents; total number of chronic conditions; time spent with physician; and total number of medications.

Results: In 2010, there were 90.3 million antidepressant office visits; 77.7 million anxiolytic/sedative/hypnotic visits; 15.5 million antipsychotic visits; and 9.5 million mood stabilizer visits. Nonpsychiatrists prescribed the majority of psychotropic medications for every class and age group; 17.3% of older adult antipsychotic visits and 44.9% of younger adult antipsychotic visits were to a psychiatrist (chi-square = 19.58, P = .001). Older adults in every medication class were less likely to have a diagnosed mental disorder.

Conclusion: Older adults prescribed psychotropic medication were less likely to have a diagnosed mental disorder than their younger counterparts. Efforts to promote quality prescribing should seek to minimize nonspecific use of psychotropic medication.

Keywords: National Ambulatory Medical Care Survey; pharmacoepidemiology; psychotropic prescribing.