Calcium channel blockers, survival and ischaemic stroke in patients with dementia: a Swedish registry study

Kalar, I.; Xu, Hong; Sečník, Juraj; Schwertner, Emilia; Kramberger, Milica G.; Winblad, Bengt; Euler, Mia von; Eriksdotter, Maria; García-Ptacek, Sara

doi:10.1111/joim.13170

Cited by 13 publications

(34 citation statements)

References 50 publications

(65 reference statements)

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“…The percentage of female participants ranged from 47.8% to 79%. Of the included studies, eight were cohort studies, [30][31][32][33][34][35][36][37] and two were case-control studies. 23,38 Studies were conducted in Germany (n = 3), 34,37,38 Sweden (n = 3), 32,35,36 Italy (n = 1), 33 Canada (n = 1), 23 France (n = 1), 33 the United Kingdom (n = 1), 30 and the United states of America (n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Of the included studies, eight were cohort studies, [30][31][32][33][34][35][36][37] and two were case-control studies. 23,38 Studies were conducted in Germany (n = 3), 34,37,38 Sweden (n = 3), 32,35,36 Italy (n = 1), 33 Canada (n = 1), 23 France (n = 1), 33 the United Kingdom (n = 1), 30 and the United states of America (n = 1). 31 Seven of the studies included general populations, 30,32,[34][35][36][37][38] two studies included community dwelling people, 23,31 and one study included hospital inpatients.…”

Section: Resultsmentioning

confidence: 99%

“…23,38 Studies were conducted in Germany (n = 3), 34,37,38 Sweden (n = 3), 32,35,36 Italy (n = 1), 33 Canada (n = 1), 23 France (n = 1), 33 the United Kingdom (n = 1), 30 and the United states of America (n = 1). 31 Seven of the studies included general populations, 30,32,[34][35][36][37][38] two studies included community dwelling people, 23,31 and one study included hospital inpatients. 33 The summary of included study characteristics and outcomes reported can be found in Tables 1 and 2, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported on ischemic stroke, 30,32,36 two studies reported bleeding-related outcomes including allcause haemorrhage, gastro-intestinal (GI) bleeding and other bleeding, 30,36 three studies reported all-cause mortality, 30,32,36 and one study reported hypoglycaemia. 34 Seven studies reported medication utilisation pattern outcomes including oral anticoagulant use before stroke hospitalisation (n = 1), 33 antithrombotic medication use before stroke hospitalisation (n = 1), 33 cardiovascular medication use for the secondary prevention of ischemic heart disease (n = 1), 31 antidepressant medication discontinuation (n = 1), 37 osteoporosis treatment (n = 1), 23 use of diabetic medications (n = 2), 34,35 and antihypertensive medication discontinuation (n = 1).…”

Section: Discussionmentioning

confidence: 99%

“…Of the included studies, seven high quality studies received 8 out of 9 stars, 30,32,[34][35][36][37][38] two high quality studies received 7 out of 9 stars, 23,31 and one moderate quality study received 6 out of 9. 33 The risk of bias for individual outcomes can be found in Table 3.…”

Section: Risk Of Biasmentioning

confidence: 99%

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Medication use to manage comorbidities in people with dementia: a systematic review

Wang

Alan

Page

et al. 2022

Pharmacy Practice and Res

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Aim To investigate physical health outcomes associated with medications prescribed to manage chronic physical conditions in people living with dementia; and determine whether a dementia diagnosis altered drug utilisation patterns for physical health conditions. Data sources Medline, Embase, Central and Scopus were searched 01/2011 to 12/2020. Study selection Experimental and observational studies, where participants with dementia using medications prescribed by doctors to prevent or treat one or more chronic comorbid physical condition, were compared to no intervention, usual care, or a non‐dementia comparison group. The outcomes of interest were clinically meaningful physical outcomes, and medication utilisation patterns. Results Ten studies met the inclusion criteria. All were of medium to high quality relative to their study design. Mixed findings were reported for ischemic stroke (n = 3), all‐cause mortality (n = 3) and bleeding‐related outcomes (n = 2). This is likely due to the heterogeneity in exposures reported. One study found that people with dementia, receiving antidiabetic management, had a higher rate of severe hypoglycaemia compared to people without dementia. Medication utilisation pattern outcomes included oral anticoagulant use before stroke‐related hospitalisation (n = 1), antithrombotic medication use before stroke‐related hospitalisation (n = 1), cardiovascular medication use for secondary prevention of ischemic heart disease (n = 1), antidepressant medication discontinuation (n = 1), osteoporosis treatment (n = 1), diabetic medication use (n = 2), and antihypertensive medication discontinuation (n = 1). Conclusion This systematic review showed there is currently insufficient evidence to conclude that medication management in people with dementia should differ substantially to people without dementia. Comprehensive and high‐quality evidence is needed to improve confidence that medication prescribing achieves optimum clinical outcomes, quality of life, and benefit‐to‐risk determination in this vulnerable population.

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