--- title: "Psychotropic medication discussions in older adults | Sutter Health" description: "To examine discussions of psychotropic medications during the older patient's visit to primary care physicians." url: "https://www.sutterhealth.org/research/publications/psychotropic-med-discussions-in-older-adults-in-pc-1055312596" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Psychotropic medication discussions in older adults # Psychotropic medication discussions in older adults' primary care office visits: So much to do, so little time. Ahn S, Tai-Seale M, Huber C Jr, Smith ML, & Ory MG. _Aging Ment Health. 15(5):618-29. doi: 10.1080/13607863.2010.548055._ 2011-07-01 ## Abstract #### 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. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/21815854) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [A case study of early experience with implementation of collaborative care in the Veterans Health Administration.](https://www.sutterhealth.org/research/publications/collaborative-care-veterans-health-administration-1055312550) Tai-Seale M, Kunik ME, Shepherd A, Kirchner J, Gottumukkala A. Popul Health Manag. 13(6):331-7. doi: 10.1089/pop.2009.0082. Epub 2010 Nov 19. 2010 Dec 01 - Publication ### [The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model.](https://www.sutterhealth.org/research/publications/use-self-regulation-1055312341) Williams LM, Pines A, Goldstein-Piekarski AN, Rosas LG, Kullar M, Sacchet MD, Gevaert O, Bailenson J, Lavori PW, Dagum P, Wandell B, Correa C, Greenleaf W, Suppes T, Perry LM, Smyth JM, Lewis MA, Venditti EM, Snowden M, Simmons JM, Ma J. Behav Res Ther. pii: S0005-7967(17)30202-4. doi: 10.1016/j.brat.2017.09.012. \[Epub ahead of print\] 2017 Oct 07 - Publication ### [Periodic health examinations and missed opportunities among patients likely needing mental health care.](https://www.sutterhealth.org/research/publications/health-exams-missed-opports-mental-health-care-1055312291) Tai-Seale M, Hatfield LA, Wilson CJ, Stults CD, McGuire TG, Diamond LC, Frankel RM, MacLean L, Stone A, Lafata JE. Am J Manag Care. 22(10):E350-7. 2016 Oct 01 - Publication ### [Serious mental illness and health-related factors associated with regional emergency department utilization.](https://www.sutterhealth.org/research/publications/serious-mental-illness-and-regional-er-use-1055312801) Azar KMJ, Petersen JP, Shen Z, Nasrallah C, Pesa J, LaMori J, Pressman A. Popul Health Manag. doi: 10.1089/pop.2019.0161. \[Epub ahead of print\] 2019 Dec 09 - Publication ### [Expressing uncertainty in clinical interactions between physicians and older patients: what matters?](https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608) Tai-Seale M, Stults C, Zhang W, Shumway M. Patient Educ Couns. 86(3):322-8. doi: 10.1016/j.pec.2011.06.005. Epub 2011 Jul 20. 2012 Mar 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/psychotropic-med-discussions-in-older-adults-in-pc-1055312596#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Psychotropic medication discussions in older adults"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/psychotropic-med-discussions-in-older-adults-in-pc-1055312596#medicalscholarlyarticle","name":"Psychotropic medication discussions in older adults' primary care office visits: So much to do, so little time.","headline":"Psychotropic medication discussions in older adults","abstract":"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. 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