An Evaluation of the Use of Psychotropic Agents Among Adults 65 Years or Older with Type 2 Diabetes

Objectives

Type 2 diabetes is comorbid with several mental health conditions such as depression, anxiety, epilepsy, and psychosis. The uprising trend in psychotropic medication use in patients with type 2 diabetes is concerning as it puts them at risk for drug interactions and worsening of their conditions. The objective of this study was to evaluate the prevalence of psychotropic agent use among adults aged 65 or older with type 2 diabetes, and to examine their use by sociodemographic and select clinical parameters.

Methods

Secondary data analyses were conducted using the cross-sectional National Health and Nutrition Examination Survey (NHANES) spanning three cohorts from 2013-2018. The inclusion criteria consisted of adults 65 years or older with type 2 diabetes. The exposure was defined as psychotropic medications use of either opioids, antipsychotics, antiepileptics, anxiolytics, or antidepressants within 30 days of the survey interview. Our predictors included sociodemographic information, biometrics and biomarkers. We used the chi-square and independent t-tests to assess association between psychotropic medications and categorical and continuous predictors, respectively. All estimates have been adjusted for complex sampling design and are nationally representative.

Results

We found that 10.9% of participants were on any psychotropic medication, and opioids were the most widely used psychotropic agent (5.7%). We found statistical significance for the associations between psychotropic use and gender, race, prescription coverage, Medicare coverage status and uncontrolled HbA1C level (p<.05). The highest prevalence of use was among females (16%), non-Hispanic whites (12.9%), and those with Medicare (12.0%) and prescription coverage (12.0%).

Conclusions

This is the first study to examine the use of psychotropic agents in individuals aged 65 and above with type 2 diabetes. The differences observed in psychotropic use are useful in increasing awareness in the practice of physicians and clinical pharmacists in planning clinical and educational interventions for patients 65 years and older with type 2 diabetes.