Citation

Choi NG, Marti CN, Kunik ME. Psychiatr. Serv. 2020; ePub(ePub): ePub.

Affiliation

Steve Hicks School of Social Work, University of Texas at Austin, Austin (Choi, Marti); Behavioral Health and Implementation Program, U.S. Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Houston (Kunik); Department of Psychiatry, Baylor College of Medicine, Houston (Kunik).

Copyright

(Copyright © 2020, American Psychiatric Association)

DOI

10.1176/appi.ps.201900551

PMID

32340595

Abstract

OBJECTIVE: The authors assessed central nervous system (CNS) polypharmacy among low-income, racially diverse homebound older adults with depression (N=277) and its associations with the participants' ratings of depressive symptoms and pain.

METHODS: CNS-active and other psychotropic and analgesic medications intake was collected from patients' medication containers. Depressive symptoms were assessed with the 24-item Hamilton Depression Rating Scale, and pain intensity was measured on an 11-point numerical rating scale. Covariates were disability (World Health Organization Disability Assessment Schedule 2.0) and perceived social support (Multidimensional Scale of Perceived Social Support).

RESULTS: Of the patients, 16% engaged in CNS polypharmacy, taking three or more CNS-active medications. Of these, 69%, 69%, and 89% were using selective serotonin reuptake inhibitors, benzodiazepines, and opioids, respectively. Higher pain intensity ratings were associated with CNS polypharmacy. Benzodiazepine users were more likely than nonusers to use opioids.

CONCLUSIONS: Medication reviews and improved access to evidence-based psychotherapeutic treatments are needed for these older individuals with depression.

Language: en

Keywords

CNS-active medications; Chronic pain; Depression; Low-income homebound older adults; Polypharmacy