Philipp Hessmann1,2, Richard Dodel3,4, Erika Baum5, Matthias J Müller6,7, Greta Paschke8, Bernhard Kis1, Jan Zeidler2, Mike Klora2, Jens-Peter Reese9, Monika Balzer-Geldsetzer3,4. 1. a Department of Psychiatry and Psychotherapy , University Medical Center Goettingen , Goettingen , Germany. 2. b Center for Health Economics Research Hannover (CHERH) , Leibniz University Hannover , Hannover , Germany. 3. c Department of Neurology , Philipps-University Marburg , Marburg , Germany. 4. d Chair of Geriatrics , University Hospital Essen, Geriatric Centre Haus Berge, Contilia GmbH , Essen , Germany. 5. e Department of General Practice , Philipps-University Marburg , Marburg , Germany. 6. f Oberberg Clinics Berlin , Berlin , Germany. 7. g Faculty of Medicine , Justus-Liebig-University Giessen , Giessen , Germany. 8. h Practice for General Medicine , Wiesbaden , Germany. 9. i Coordinating Center for Clinical Trials , Philipps-University Marburg , Marburg , Germany.
Abstract
OBJECTIVE: A restrictive use of antipsychotic drugs in patients with Alzheimer's disease (AD) is recommended due to an increased risk of cerebrovascular events and mortality. We hypothesise that the prescription of antipsychotics is associated with the patients' socio-demographic and clinical status (e.g., dementia severity). METHODS: The prescription of antipsychotics was cross-sectionally evaluated in 272 community-dwelling and 123 institutionalised patients with AD across all severity stages of dementia. The patients' clinical characteristics covered the cognitive status, neuropsychiatric symptoms, daily activities, and quality of life (HrQoL). To determine associations with the use of antipsychotics bivariate and logistic regression analyses were conducted. RESULTS: Totally, 25% of the patients were treated with antipsychotics. significantly less frequently than nursing home inhabitants (15.1% vs. 45.5%). Severely demented patients (MMSE 0-9) received antipsychotics most often (51.5%). Additionally, multiple regression analyses revealed a higher chance of prescription for participants with depressive symptoms (OR 2.3, 95% CI: 1.019-5.160) and those treated by neuropsychiatric specialists (OR 3.4, 95% CI: 1.408-8.328). CONCLUSIONS: Further longitudinal studies are required to assess the appropriateness of indications for antipsychotics and the reasons for a higher use in nursing home inhabitants and patients with severe dementia and depression.
OBJECTIVE: A restrictive use of antipsychotic drugs in patients with Alzheimer's disease (AD) is recommended due to an increased risk of cerebrovascular events and mortality. We hypothesise that the prescription of antipsychotics is associated with the patients' socio-demographic and clinical status (e.g., dementia severity). METHODS: The prescription of antipsychotics was cross-sectionally evaluated in 272 community-dwelling and 123 institutionalised patients with AD across all severity stages of dementia. The patients' clinical characteristics covered the cognitive status, neuropsychiatric symptoms, daily activities, and quality of life (HrQoL). To determine associations with the use of antipsychotics bivariate and logistic regression analyses were conducted. RESULTS: Totally, 25% of the patients were treated with antipsychotics. significantly less frequently than nursing home inhabitants (15.1% vs. 45.5%). Severely demented patients (MMSE 0-9) received antipsychotics most often (51.5%). Additionally, multiple regression analyses revealed a higher chance of prescription for participants with depressive symptoms (OR 2.3, 95% CI: 1.019-5.160) and those treated by neuropsychiatric specialists (OR 3.4, 95% CI: 1.408-8.328). CONCLUSIONS: Further longitudinal studies are required to assess the appropriateness of indications for antipsychotics and the reasons for a higher use in nursing home inhabitants and patients with severe dementia and depression.
Entities:
Keywords:
Antipsychotics; BPSD; community-dwelling; dementia; nursing home
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