Review Article| Volume 22, ISSUE 6, P1206-1214.e5, June 2021

The Prevalence and Characteristics of Psychotropic-Related Hospitalizations in Older People: A Systematic Review and Meta-Analysis

  • Ilsa R. Wojt
    The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia
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  • Rose Cairns
    The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia

    NSW Poisons Information Center, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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  • Alexander J. Clough
    The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia
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  • Edwin C.K. Tan
    Address correspondence to Edwin C. K. Tan, PhD, Pharmacy Building A15, Science Rd, The University of Sydney, Camperdown, NSW 2006, Australia.
    The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia

    Center for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia

    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Published:February 01, 2021DOI:



      To assess the prevalence and characteristics of psychotropic medication-related hospitalizations in older people.


      Systematic review with meta-analysis.

      Setting and Participants

      Older adults (≥65 years of age) with psychotropic-related hospitalizations.


      A search of published literature was performed in Medline, Embase, CINAHL, and Scopus from 2010 to March 2020. Three authors independently screened titles, abstracts, and full texts of relevant studies for relevance. Two authors independently extracted full text data, including characteristics, measures of causality, prevalence data, and performed quality assessment. A meta-analysis was conducted to estimate pooled prevalence and 95% confidence intervals (CIs) of psychotropic-related hospitalizations using random effects models. Heterogeneity was explored using subgroup analyses.


      Of 815 potentially relevant studies, 11 were included in the final analysis. Five studies were cross-sectional studies, 5 were cohort studies, and 1 was a case control study. The majority of studies were rated as good quality. Psychotropic medications contributed to 2.1% (95% CI 1.2%–3.3%) of total hospitalizations and 11.3% (95% CI 8.2%–14.8%) of adverse drug event-related hospitalizations. The main psychotropic medications attributable to hospitalizations were antidepressants, hypnotics, sedatives, and antipsychotics.

      Conclusions and Implications

      Psychotropic medications are a significant contributor to hospitalizations in older adults. The risk of hospitalization was greatest for those taking antidepressants, antipsychotics, hypnotics, and sedatives. Future studies should aim to address specific medication subgroups and implement uniform adverse drug event-related classification systems to improve comparability across studies.


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