Bakouni H, et al. - The factors associated with off-label use of antipsychotics in community-living older adults were evaluated in this study. It was found that the majority of antipsychotics prescribed to community living older adults were off-label. Such a use was more likely in complex clinical cases with multiple outpatient visits and other psychotropic drugs use. In order to determine the long-term effects correlated with off-label use of antipsychotics, advanced research was needed.

Methods

• Older adults (n = 4108), covered under a public drug insurance plan in Canada constituted the study sample.
• The researchers defined off-label use of antipsychotics by the absence of an approved indication for this use, according to Health Canada's drug product database.
• They used multinomial logistic regression to evaluate the factors associated with off-label use.

Results

• In this study, the prevalence of antipsychotics use was 2.5%, of which 78% was off-label.
• Off-label antipsychotics use was negatively correlated with advanced age (≥75 vs 65-74 years old) (OR: 0.46; 95%CI: 0.27-0.78); and positively associated with higher education level (OR: 2.68; 95% CI: 1.64-4.40), higher number of outpatient visits (≥6) (OR: 2.39; 95%CI: 1.34-4.25), antidepressant or benzodiazepine use (OR: 5.81; 95%CI: 3.31–10.21), and the presence of an organic brain syndrome & Alzheimer's (OR: 5.73; 95%CI: 1.74-18.89) compared to non-use.
• Off-label use was less likely in those with major depression (OR: 0.02; 95%CI: <0.01-0.11) and with insomnia (OR: 0.13; 95%CI: 0.02-0.91) compared to labeled use.