Psychotropic Medication Use in a Sample of Frail,Elderly Inpatients in Sydney,Australia

Objective: To examine rates of use and predictors of psychotropic drug use among a group of frail, aged inpatients admitted under the care of a geriatrician. To examine correlates of psychotropic drug use at discharge with inpatient characteristics. Method: The number of psychotropic medications taken were obtained from a medical records audit of 311 frail inpatients under the care of a geriatrician. Medication taken at the point of admission and at discharge, and rates of commencement and cessation of different psychotropic agents were measured. Results: Patients discharged to a nursing home were more likely to be admitted and discharged on anti-psychotics and anxiolytics/hypnotics. Subjects from an English-speaking background were more likely to be prescribed anti-depressants on discharge and there was a trend for females to be discharged on anxiolytic/hypnotic medication. Subjects discharged on anti-psychotics were also more likely to have lower MMSE scores and higher average DRG cost weights. However, lower numbers of patients admitted from nursing homes and hostels were discharged on psychotropic medication. For those discharged home, the reverse was true. Conclusion: The finding that fewer nursing home and hostel patients were discharged on such medication that admitted on it, suggests that careful review of psychotropics for frail aged inpatients admitted under the care of a geriatrician is practised.