Analysis of Quantitative Studies on Administration of Sertraline

Introduction and Background

A good proportion of the U.S population comprises the older population: Around 12 percent of the U.S population is composed of people aged 65 years and above. Nonetheless, the older population accounts for 30 percent of all over-the-counter medication use and around 34 percent of prescription medication use (Gasparyan et al., 2021). (Gasparyan et al., 2021). The majority of the older population often suffer from depression. The depressive symptoms are depressed by the administration of antidepressants such as sertraline. Nonetheless, inappropriate administration is often common in hospitals. The study will analyze two articles that focus on the administration of sertraline.

One of the articles talks about inappropriate prescription of drugs, including sertraline, among Brazilian older people with Alzheimer’s disease. Many inappropriate medications (PMIs) have been associated with older people; the leading user of medications is the old generation (Ferreira et al., 2021). (Ferreira et al., 2021). The article evaluates inappropriate descriptions of medication among old Brazilians with Alzheimer’s disease. The major objective of the study is to determine the prevalence of PMIs among older people with Alzheimer’s disease. The research was; what is the prevalence of inappropriate prescriptions among older people with Alzheimer’s disease?

Another article conducts a comparative analysis on serotonin reuptake and fall risk among older people. Research shows that around 20 percent of older people use antidepressant medication (Haddad et al., 2019). (Haddad et al., 2019). Nonetheless, most studies have not assessed the fall risk depending on the prescribed medications. Thus, the articles determine the association between selective serotonin reuptake inhibitors (SSRI) and the risk of falls among older adults. The major objective of the study was to determine the association between SSRI and self-reported falls among older adults. The study does not state the research question. Nonetheless, the research question can be stated as; is there a relationship between SSRI and self-reported falls in older people?

 

Methods of Study

 

The first article used 234 patients with Alzheimer’s to conduct the research. The research used data from interviews with the patients and their caregivers. Furthermore, more information was obtained from the Drugs of Exceptional Distribution system. Patients who visited the pharmacy were interviewed between July 2017 and September 2017. The PIMs were identified using the 2019 Beers criteria (Ferreira et al., 2021). (Ferreira et al., 2021).

 

The second article uses participants who participated in the previous three panels surveyed in the past two years. Furthermore, the participants had to have taken SSRI during the baseline years and were limited to older community-dwelling Medicare beneficiaries (> 65 years) enrolled in Medicare part D (Haddad et al., 2019). (Haddad et al., 2019). The health and demographic characteristics of the participants and recurrent falls, self-reported falls in the past year. Medication use factors included duration, frequency, and dose of use. Individual SSRI (escitalopram or citalopram vs. sertraline) was compared with self-reported falling and monthly total standardized daily dose (TSDD) (TSDD). Data analysis was done using multivariable logistic regressions and descriptive analysis.

 

The two articles use quantitative analysis to determine the effects of inappropriate prescription of drugs, sertraline. Both articles use statistical techniques to analyze data; the first article presents the outcomes in absolute and relative frequency. Furthermore, heterogeneity of proportions was determined using the chi-square test. On the other hand, Poisson regression was used to establish an association between PIP and exposure variables. The second article uses multivariable logistic regressions and descriptive analysis.

 

Result of the Study

 

The first article’s findings reported 327 instances of inappropriate medication. A total of 60 PMIs were recorded with cardiovascular and central nervous system diseases. Antipsychotic Quetiapine was the most prescribed PIM. Furthermore, of the 1073 medications prescribed, the prevalence of PIP (Potentially inappropriate prescribing) was around 67 percent , while More than 30 percent were PIMs. Besides, the results showed that patients using PIMs had a higher prevalence of polypharmacy, comorbidities, psychosis, and depression (Ferreira et al., 2021). (Ferreira et al., 2021). Non-pharmacologic options are used to manage psychological and behavioral symptoms of dementia.

 

Nonetheless, the utility of non-pharmacologic options is limited by the disadvantages associated with non-pharmacologic therapies. Among the prescribed PIMs were sertraline and escitalopram antidepressants. Improper administration of sertraline may cause falls, syncope, psychomotor dysfunction, risk of ataxia, and orthostatic hypertension.

 

The second article shows that the most commonly prescribed SSRIs are sertraline and citalopram/ escitalopram: Around 45 percent of the participants used citalopram while around 29 percent used sertraline. More than 39 percent and 36 percent of participants reported falls in the year following medication use (Haddad et al., 2019). (Haddad et al., 2019). No significant difference was registered on both SSRIs in low and medium TSDD levels in the risk of recurrent and self-reported falls. Nonetheless, results showed that high TSDD citalopram had a higher risk of recurrent falls compared to high TSDD of sertraline.

 

Outcomes Comparison

 

The first article shows that inappropriate prescription of drugs is common among older people. These findings imply that inappropriate administration of sertraline as a treatment of depression is most common within eight weeks since the patient is less likely to respond to medication since most physicians tend to overprescribe or under-prescribe the medications. Therefore, for the PICOT question, in the elderly population, aged 65 years and above, inappropriate administration of sertraline is more common than appropriate administration within the first eight weeks. Nonetheless, the hospitals should lay out strategies that ensure correct medication among older adults. The second article shows the effects of different doses of sertraline and citalopram on older adults. The results showed that high doses of sertraline are safer for recurrent falls than high doses of citalopram. Thus, according to the two articles, different doses of antidepressants leads to different effects, negative or positive. More research on the effects of antidepressants will further inform prescription and fall risk management for older people.

 

Conclusion

 

The hospitals can assist in maintaining the health of older adults by appropriately prescribing, administering, monitoring, and cost-effectively providing medications. Appropriate prescription and administration of drugs will help the older population recover from illnesses and control symptoms of chronic disease. The older population can live longer and stronger if they follow pharmacists’ and doctors’ medications. Nonetheless, the medical practitioners should clearly understand the effects of different medications at different periods: antidepressants are the commonly prescribed medications globally; nonetheless, most physicians have imperfect knowledge of their indications for use and their clinical effectiveness (Hasani et al., 2019). (Hasani et al., 2019).

 

References

Ferreira, T. R., Lopes, L. C., Motter, F. R., & de Cássia Bergamaschi, C. (2021). Potentially inappropriate prescriptions to Brazilian older people with Alzheimer disease: A cross-sectional study. Medicine, 100(12), e25015.

Gasparyan, A., Navarrete, F., & Manzanares, J. (2021). The administration of sertraline plus naltrexone reduces ethanol consumption and motivation in a long-lasting animal model of post-traumatic stress disorder—neuropharmacology, 189, 108552.

Haddad, Y. K., Kakara, R., & Marcum, Z. A (2019). A comparative analysis of selective serotonin reuptake inhibitors and fall risk in older adults. Journal of the American Geriatrics Society.

Hasani, R., Sarma, J., & Kansal, S. (2019). Serotonin syndrome induced by combined use of sertraline and linezolid. Anesthesia, essays and researches, 13(1), 188.