(P-184) Prevalence and Predictors of Potentially Inappropriate Psychotropic (PIP) Medications in Older Adults with Psychiatric Illness

Background: In older adults, polypharmacy and potentially inappropriate psychotropic (PIP) medication use are increasing at an unprecedented rate. However, there is limited information available on the use of PIP medication in older adults having psychiatry illness.

Objectives: To determine the prevalence and predictors of PIP in older adults with psychiatric illness with respect to Beers criteria 2019 and Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) 2015 and identify predictors of PIP.

Methods: A cross-sectional study was performed at the tertiary care teaching hospital's psychiatry department on 456 older adults, with a median age of 65 years visiting the outpatient psychiatry department. All patients aged 65 years or older, visiting the outpatient psychiatry department, prescribed with at least one psychotropic medication was included in the study after written informed consent. Bivariate logistic regression was used to figure outestimate the predictors of PIP medication. Variables such as Age, gender, education qualification, nature of visit, region of living, number of psychotropic medication, income were considered for analysis. Long-acting benzodiazepine like clonazepam, chlordiazepoxide were identified as one of the most commonly prescribed PIP medications with respect to the both set of criteria.

Results: Results of the study reflects a staggering number of older adults, (more than 91% and 73%) out of total 456 patients were prescribed with at least one PIP medication as per Beers criteria and STOPP criteria, respectively. Further analysis revealed that polypharmacy (≥5 medications with odds Ratio (OR) 17.33, 95% Confidence Interval (CI) 1.42-210.66, P-0.025) as the sole important predictor for PIP medication as per Beers criteria 2019 but it was not found to be the predictor of PIP as per STOPP criteria 2015.

Conclusions: According to the Beers criterion and the STOPP criteria, the use of PIP medicine is very prevalent among older adults with psychiatric illness. The Beers criteria dramatically diagnose more PIP medication than STOPP criteria. Polypharmacy has emerged as one of the risk factors for PIP medication use in older adults.