Antipsychotic prescribing to older people living in care homes and the community in England and Wales

Shah, Sunil; Carey, Iain M.; Harris, Tess; DeWilde, Stephen; Cook, Derek G

doi:10.1002/gps.2557

Cited by 54 publications

(39 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings differ from general population studies that found higher psychotropic prescribing levels in more deprived areas in people without dementia [26]. Perhaps government policies in the past decade, including targets incentivising GPs to identify and review annually people with dementia may have reduced inequities.…”

Section: Discussioncontrasting

confidence: 99%

Inequalities in receipt of mental and physical healthcare in people with dementia in the UK

Cooper¹,

Lodwick

Walters

et al. 2016

Age Ageing

View full text Add to dashboard Cite

BackgroundUK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia.Methodswe investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002–13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men.Resultsonly half of people with dementia received a documented annual review. Deprivation was not associated with healthcare received. Compared to men with dementia, women with dementia had lower rates of surgery consultations (adjusted incidence rate ratio (IRR) 0.90, 95% CI 0.90–0.91), of annual blood pressure monitoring (adjusted IRR 0.96, 95% CI 0.95–0.97) and of annual weight monitoring (adjusted IRR 0.91, 95% CI 0.90–0.93). Men with dementia were less likely to be taking psychotropic medication than women with dementia. People with dementia had fewer surgery consultations and were less likely to have their weight and blood pressure monitored at least annually, compared to the non-dementia group.Conclusionspeople with dementia, in particular women, appear to receive less primary healthcare, but take more psychotropic medication that may negatively impact their physical health. Reducing these inequalities and improving access of people with dementia to preventative healthcare could improve the health of people with dementia.

show abstract

Section: Discussioncontrasting

confidence: 99%

Inequalities in receipt of mental and physical healthcare in people with dementia in the UK

Cooper¹,

Lodwick

Walters

et al. 2016

Age Ageing

View full text Add to dashboard Cite

show abstract

“…This increase was also potentiated by the introduction of "second generation" or atypical antipsychotics such as quetiapine, risperidone, olanzapine, clozapine and aripiprazole (Kessler et al, 2003), which in contrast to "first generation" or typical antipsychotics, have a higher clinical efficacy and a lower risk of inducing adverse extrapyramidal symptoms (movement disorders) (Monshat et al, 2010;Shah et al, 2011). Antipsychotic drugs, mainly the atypical ones (Monshat et al, 2010;Shah et al, 2011), are used in the pharmacological treatment of mood disorders such as depression and bipolar disease (39% of all antipsychotics use) (Mark, 2010), and psychotic disorders, in particular schizophrenia (35% of all antipsychotics use). A small percentage (7.4%) is prescribed for delirium, dementia, amnesia or other neuropsychiatric disorders (Mark, 2010).…”

Section: Antipsychotic Drugsmentioning

confidence: 98%

Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms

Gonçalves¹,

Araújo²,

Martel³

2015

European Neuropsychopharmacology

View full text Add to dashboard Cite

“…Merely 3 studies were performed within a population of elderly patients, 30Y32 yielding conflicting results. No previous study explicitly focused on patients with dementia, although APDs are primarily prescribed in this group, 4 and risk factors (eg, immobilization) for VTE are more prevalent compared with nondemented peers. 33 Therefore, we conducted a nested case-control study to investigate the association of APD use and VTE within a cohort of elderly patients with a coded diagnosis of dementia.…”

mentioning

confidence: 97%

Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients With Dementia

Schmedt

Garbe²

2013

Journal of Clinical Psychopharmacology

View full text Add to dashboard Cite

The aim of this study was to investigate the association between the use of antipsychotics and the risk of venous thromboembolism (VTE) in elderly patients with dementia. Based on data from the German Pharmacoepidemiological Research Database, a nested case-control study was conducted within a cohort of 72,591 patients with dementia aged at least 65 years at cohort entry. Cases were patients with a hospitalization due to VTE. Up to 4 controls were matched to each case according to age, sex, health insurance, and calendar time of the VTE. Users of antipsychotics were classified into current or former users, and in addition, all current users were categorized as prevalent or new users. For a further analysis, we distinguished between users of either conventional or atypical antipsychotics or concurrent users of both conventional and atypical antipsychotics. Multivariate conditional logistic regression was applied to calculate odds ratios (ORs) of VTE for all user groups compared with nonusers. The case-control data set comprised 1028 VTE cases and 4109 controls. An increased risk of VTE was found for current users (OR, 1.23; 95% confidence interval [CI], 1.01-1.50) and for users of a combination of atypical and conventional antipsychotics (OR, 1.62; 95% CI, 1.15-2.27). In current users, only new use was associated with an increased risk (OR, 1.63; 95% CI, 1.10-2.40). Increased attention to clinical signs of VTE should be paid during the first 3 months of treatment with antipsychotics and in patients receiving both conventional and atypical agents, especially if other risk factors for VTE exist.

show abstract

Antipsychotic prescribing to older people living in care homes and the community in England and Wales

Cited by 54 publications

References 26 publications

Inequalities in receipt of mental and physical healthcare in people with dementia in the UK

Inequalities in receipt of mental and physical healthcare in people with dementia in the UK

Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms

Antipsychotic Drug Use and the Risk of Venous Thromboembolism in Elderly Patients With Dementia

Contact Info

Product

Resources

About