TY - JOUR
KW - Aged
KW - Aged, 80 and over
KW - Drug Utilization/statistics & numerical data
KW - Female
KW - Health Care Surveys
KW - Humans
KW - Logistic Models
KW - Male
KW - Mental Disorders/drug therapy
KW - Middle Aged
KW - office visits
KW - Patient Education as Topic
KW - Physician's Practice Patterns/statistics & numerical data
KW - Physician-Patient Relations
KW - Primary Health Care/organization & administration
KW - Psychotropic Drugs/therapeutic use
KW - Quality of Health Care
KW - Video Recording
KW - Workload
AU - S. Ahn
AU - M. Tai-Seale
AU - C. Huber Jr
AU - M. L. Smith
AU - M. G. Ory
A1 - 
AB - OBJECTIVES: To examine discussions of psychotropic medications during the older patient's visit to primary care physicians, identify how physician's competing demands influence these discussions, describe different scenarios physicians utilize to address mental health complaints of older adults, and recommend best practices for diagnosing and treating such patients. METHOD: Convenience sample of 59 videotapes of primary care office visits involving mental health discussions in the United States complemented by patient and physician surveys. Videotaped visits were examined using logistic regression for grouped-level data to explore contributions of physician's competing demands to the likelihood of having psychotropic medication discussions. Tape transcripts were selected to provide examples of prescribing and referral behaviors. RESULTS: One-third of these visits contained no psychotropic medication discussions despite its important role in treating mental illnesses. When prescribing psychotropic medicines, physicians presented information about the medication's purpose and brand name more often than adverse effects or usage. More competing demands (i.e., more topics discussed or more leading causes of disability addressed during the visit) were associated with less psychotropic medication discussions. Selected case scenarios illustrate the importance of acknowledging mental illness, prescribing psychotropic medications, explaining the medications, and/or referring patients to mental health providers to address their mental health complaints. CONCLUSION: Competing demands may constrain discussions of psychotropic medications. Given the seriousness of mental illness in late life, system-level changes may be needed to correctly diagnose mental illness, take more proactive actions to improve mental health, and enhance information exchange concerning psychotropic medication in a manner that meets patients' needs.
BT - Aging & mental health
C5 - Education & Workforce; Health Disparities
CP - 5
CY - England
DO - 10.1080/13607863.2010.548055
IS - 5
JF - Aging & mental health
N2 - OBJECTIVES: To examine discussions of psychotropic medications during the older patient's visit to primary care physicians, identify how physician's competing demands influence these discussions, describe different scenarios physicians utilize to address mental health complaints of older adults, and recommend best practices for diagnosing and treating such patients. METHOD: Convenience sample of 59 videotapes of primary care office visits involving mental health discussions in the United States complemented by patient and physician surveys. Videotaped visits were examined using logistic regression for grouped-level data to explore contributions of physician's competing demands to the likelihood of having psychotropic medication discussions. Tape transcripts were selected to provide examples of prescribing and referral behaviors. RESULTS: One-third of these visits contained no psychotropic medication discussions despite its important role in treating mental illnesses. When prescribing psychotropic medicines, physicians presented information about the medication's purpose and brand name more often than adverse effects or usage. More competing demands (i.e., more topics discussed or more leading causes of disability addressed during the visit) were associated with less psychotropic medication discussions. Selected case scenarios illustrate the importance of acknowledging mental illness, prescribing psychotropic medications, explaining the medications, and/or referring patients to mental health providers to address their mental health complaints. CONCLUSION: Competing demands may constrain discussions of psychotropic medications. Given the seriousness of mental illness in late life, system-level changes may be needed to correctly diagnose mental illness, take more proactive actions to improve mental health, and enhance information exchange concerning psychotropic medication in a manner that meets patients' needs.
PP - England
PY - 2011
SN - 1364-6915; 1360-7863
SP - 618
EP - 629
EP - 
T1 - Psychotropic medication discussions in older adults' primary care office visits: So much to do, so little time
T2 - Aging & mental health
TI - Psychotropic medication discussions in older adults' primary care office visits: So much to do, so little time
U1 - Education & Workforce; Health Disparities
U2 - 21815854
U3 - 10.1080/13607863.2010.548055
VL - 15
VO - 1364-6915; 1360-7863
Y1 - 2011
ER -