{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:08:48Z","timestamp":1789830528750,"version":"4.0.1"},"reference-count":35,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec id=\"S2056472424007981_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Central nervous system (CNS)-active polypharmacy is frequent and potentially harmful in older patients. Data on its burden outside the USA and European countries remain limited.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007981_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To estimate the period prevalence of and factors associated with out-of-hospital CNS-active polypharmacy in older adults.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007981_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We used data from a cohort of out-patients aged \u226560 years affiliated to the Hospital Italiano de Buenos Aires\u2019 health maintenance organisation on 1 January 2021. A CNS-active polypharmacy event was defined as the concurrent exposure to \u22653 CNS-active medications (i.e. antidepressants, anti-epileptics, antipsychotics, benzodiazepines, Z-drugs and opioids) through filled out-of-hospital prescriptions. We calculated the period prevalence of CNS-active polypharmacy for 2021. We identified factors associated with CNS-active polypharmacy using a multivariable logistic regression model to estimate odds ratios and 95% confidence intervals (CI).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007981_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>We included 63 857 patients. Pre-existing mental health diagnoses included anxiety (21%), depressive (14%) and sleep (11%) disorders. CNS-active polypharmacy occurred in 4535 patients, for a period prevalence of 7.1% (95% CI: 6.9\u20137.3%). The combination of an antidepressant, an antipsychotic and a benzodiazepine accounted for 21% of the CNS-active polypharmacy events. Frontotemporal dementia (odds ratio: 14.67; 95% CI: 4.47\u201348.20), schizophrenia (odds ratio: 7.93; 95% CI: 4.64\u201313.56), bipolar disorder (odds ratio: 7.20; 95% CI: 5.45\u20139.50) and depressive disorder (odds ratio: 3.50; 95% CI: 3.26\u20133.75) were associated with CNS-active polypharmacy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007981_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>One in 14 adults aged 60 years and older presented out-of-hospital CNS-active polypharmacy. Future studies should evaluate measures to reduce CNS-active medication use in this population.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2024.798","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T07:02:01Z","timestamp":1730185321000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of central nervous system-active polypharmacy in a cohort of older adults in Argentina"],"prefix":"10.1192","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4538-4197","authenticated-orcid":false,"given":"Augusto","family":"Ferraris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Angriman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Barrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Penizzotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol","family":"Faerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Washington","family":"Rivadeneira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Chiessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaspar","family":"Mura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Alberto","family":"Poll\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro G.","family":"Szmulewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"S2056472424007981_ref18","unstructured":"18 WHO Collaborating Centre for Drug Statistics Methodology (WHOCC). ATC\/DDD Index. WHOCC, 2024 (https:\/\/www.whocc.no\/atc_ddd_index\/ [cited 16 Jan 2023)]."},{"key":"S2056472424007981_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glz270"},{"key":"S2056472424007981_ref16","unstructured":"16 Hospital Italiano de Buenos Aires. Hospital Italiano de Buenos Aires: Acerca del Hospital. Hospital Italiano de Buenos Aires, 2023 (https:\/\/www.hospitalitaliano.org.ar [cited 10 Jun 2023])."},{"key":"S2056472424007981_ref15","unstructured":"15 Joint Commission International. A Global Leader for Health Care Quality and Patient Safety. Joint Commission International, n.d. (https:\/\/www.jointcommissioninternational.org\/ [cited 4 Jul 2023])."},{"key":"S2056472424007981_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0621-2"},{"key":"S2056472424007981_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2020.07.004"},{"key":"S2056472424007981_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.31647"},{"key":"S2056472424007981_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13702"},{"key":"S2056472424007981_ref11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.1195"},{"key":"S2056472424007981_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocab084"},{"key":"S2056472424007981_ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-020-01582-4"},{"key":"S2056472424007981_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02127.x"},{"key":"S2056472424007981_ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07336-7"},{"key":"S2056472424007981_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-035978"},{"key":"S2056472424007981_ref12","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.9225"},{"key":"S2056472424007981_ref14","doi-asserted-by":"publisher","DOI":"10.1590\/1413-812320212611.06152021"},{"key":"S2056472424007981_ref29","doi-asserted-by":"publisher","DOI":"10.1159\/000022013"},{"key":"S2056472424007981_ref27","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-160828"},{"key":"S2056472424007981_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-023-00777-y"},{"key":"S2056472424007981_ref25","first-page":"e8192","article-title":"A qualitative study on the elderly and accessibility to health services during the COVID-19 lockdown in Buenos Aires, Argentina - part 2","volume":"21","author":"Loza","year":"2021","journal-title":"Medwave"},{"key":"S2056472424007981_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab116"},{"key":"S2056472424007981_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06965-5"},{"key":"S2056472424007981_ref10","unstructured":"10 Food and Drug Administration (FDA). FDA Drug Safety Communication: FDA Warns about Serious Risks and Death when Combining Opioid Pain or Cough Medicines with Benzodiazepines; Requires its Strongest Warning. FDA, 2019 (https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-warns-about-serious-risks-and-death-when-combining-opioid-pain-or [cited 22 Aug 2023])."},{"key":"S2056472424007981_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14094"},{"key":"S2056472424007981_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(21)00054-4"},{"key":"S2056472424007981_ref20","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5490"},{"key":"S2056472424007981_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02192-1"},{"key":"S2056472424007981_ref9","first-page":"jgs.18372","article-title":"American geriatrics society 2023 updated AGS beers criteria\u00ae for potentially inappropriate medication use in older adults","year":"2023","journal-title":"J Am Geriatr Soc"},{"key":"S2056472424007981_ref6","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.20071038"},{"key":"S2056472424007981_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-021-01497-8"},{"key":"S2056472424007981_ref4","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4483"},{"key":"S2056472424007981_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/26.4.404"},{"key":"S2056472424007981_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k3532"},{"key":"S2056472424007981_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034346"},{"key":"S2056472424007981_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5567"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472424007981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T07:02:06Z","timestamp":1730185326000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472424007981\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,29]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["S2056472424007981"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2024.798","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,29]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e190"}}