Potentially inappropriate medications and treatment adherence in older adults with depressive disorder: A population-based cohort study

AIM: The objective is to study the prevalence of potentially inappropriate medications (PIMs) and analyze the relationship between PIM regimens and therapeutic adherence to antidepressant treatment in older adults diagnosed with depression within a Spanish population cohort. METHODS: This retrospective, population-based cohort study used real-world data from older patients diagnosed with depression in the Canary Islands, Spain between 2013 and 2021. The prevalence of PIMs was determined using sets of criteria developed in the USA (Beers), Ireland (STOPP) and Germany (PRISCUS). Multivariate logistic regression models were performed to assess factors associated with PIM prescriptions and treatment adherence, including sociodemographic, clinical, and lifestyle variables RESULTS: Among the 12,272 patients over 65 years of age undergoing antidepressant treatment for late-life depression, the prevalence of PIM use ranged between 73 % and 89 %. A protective effect of increasing age and male sex was found. Patients with a higher number of psychiatric and nursing comorbidities showed a higher risk of receiving a PIM. A consistent trend was observed, the risk of non-adherence to treatment increases with the number of PIMs received. CONCLUSION: The findings here indicate a worrying prevalence of PIM prescription in this population. A higher risk of receiving a PIM was observed in comparatively younger older adults, women, and those with psychiatric or nursing comorbidities, with potential implications for treatment adherence. However, these results should be interpreted with caution. Further research is needed to clarify the relationship between adherence and PIM.