Psychotropic Polypharmacy in Patients with Dementia: Prevalence and Predictors
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Psychotropic Polypharmacy in Patients with Dementia : Prevalence and Predictors. / Nørgaard, Ane; Jensen-Dahm, Christina; Gasse, Christiane; Hansen, Elsebet Steno; Waldemar, Gunhild.
I: Journal of Alzheimer's Disease, Bind 56, Nr. 2, 2017, s. 707-716.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Psychotropic Polypharmacy in Patients with Dementia
T2 - Prevalence and Predictors
AU - Nørgaard, Ane
AU - Jensen-Dahm, Christina
AU - Gasse, Christiane
AU - Hansen, Elsebet Steno
AU - Waldemar, Gunhild
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Antipsychotics and other psychotropics are frequently used to treat neuropsychiatric symptoms in patients with dementia, even though the evidence for effect is limited. Concerns have been raised about the safety of antipsychotics, but concomitant use of multiple psychotropic drug classes (psychotropic polypharmacy) may also pose a risk for patients.OBJECTIVE: To investigate the prevalence and predictors associated with use of psychotropic polypharmacy in patients with dementia.METHODS: A population-based study using nationwide registers. Patients with dementia were identified among all Danish residents ≥65 years on January 1, 2012. Data on prescriptions and comorbidity was included in the analysis. Overlapping prescriptions for different psychotropic drug classes were used to determine psychotropic polypharmacy. A multivariable logistic regression analysis was conducted to evaluate factors independently associated with the prescription of other psychotropic drug classes among patients already using antipsychotics.RESULTS: Among all patients registered with dementia (34,553), 25.3% (8,728) used ≥2 psychotropic drugs. Among patients treated with antipsychotics 75.8% (5,403) used at least one other psychotropic drug during the antipsychotic treatment period. Nursing home residency, number of non-psychotropic medications used in 2011, and prior psychiatric diagnosis were associated with psychotropic polypharmacy among antipsychotic drug users. The most frequent combination of psychotropic drugs was antipsychotics and antidepressants.CONCLUSION: Concomitant use of psychotropic drugs was frequent in dementia patients. Patients living in nursing homes had the highest risk of receiving a combination of antipsychotics and other psychotropic drugs. Concomitant use of psychotropics may cause adverse events, and potential consequences for patients' safety call for further investigation.
AB - BACKGROUND: Antipsychotics and other psychotropics are frequently used to treat neuropsychiatric symptoms in patients with dementia, even though the evidence for effect is limited. Concerns have been raised about the safety of antipsychotics, but concomitant use of multiple psychotropic drug classes (psychotropic polypharmacy) may also pose a risk for patients.OBJECTIVE: To investigate the prevalence and predictors associated with use of psychotropic polypharmacy in patients with dementia.METHODS: A population-based study using nationwide registers. Patients with dementia were identified among all Danish residents ≥65 years on January 1, 2012. Data on prescriptions and comorbidity was included in the analysis. Overlapping prescriptions for different psychotropic drug classes were used to determine psychotropic polypharmacy. A multivariable logistic regression analysis was conducted to evaluate factors independently associated with the prescription of other psychotropic drug classes among patients already using antipsychotics.RESULTS: Among all patients registered with dementia (34,553), 25.3% (8,728) used ≥2 psychotropic drugs. Among patients treated with antipsychotics 75.8% (5,403) used at least one other psychotropic drug during the antipsychotic treatment period. Nursing home residency, number of non-psychotropic medications used in 2011, and prior psychiatric diagnosis were associated with psychotropic polypharmacy among antipsychotic drug users. The most frequent combination of psychotropic drugs was antipsychotics and antidepressants.CONCLUSION: Concomitant use of psychotropic drugs was frequent in dementia patients. Patients living in nursing homes had the highest risk of receiving a combination of antipsychotics and other psychotropic drugs. Concomitant use of psychotropics may cause adverse events, and potential consequences for patients' safety call for further investigation.
KW - Aged
KW - Aged, 80 and over
KW - Comorbidity
KW - Dementia/drug therapy
KW - Denmark
KW - Female
KW - Homes for the Aged
KW - Humans
KW - Logistic Models
KW - Male
KW - Multivariate Analysis
KW - Nursing Homes
KW - Odds Ratio
KW - Polypharmacy
KW - Prevalence
KW - Psychotropic Drugs/therapeutic use
KW - Registries
KW - Risk Factors
U2 - 10.3233/JAD-160828
DO - 10.3233/JAD-160828
M3 - Journal article
C2 - 28035931
VL - 56
SP - 707
EP - 716
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 2
ER -
ID: 195189200