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Gedde, Marie Hidle; Husebø, Bettina S.; Vahia, Ipsit V.; Mannseth, Janne; Vislapuu, Maarja; Naik, Mala; Berge, Line Iden

doi:10.1136/bmjopen-2021-050628

Cited by 18 publications

(12 citation statements)

References 31 publications

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Section: Discussionmentioning

confidence: 84%

“…Although specific causes for the increase in the rates of antipsychotic drug prescribing may vary and cannot be identified by the current data, the increase may in part be associ- ated with both a deterioration in behavioral and psychological symptoms of dementia and reduced access to care following the introduction of COVID-19 restrictions. 6,22 Although country-specific containment and health policies differed, most governments, at least in the acute phase of the pandemic, introduced national-level lockdowns encompassing stay-at-home requirements and restrictions on gatherings and internal movement. 23 These restrictions confined people with dementia to their own home or even bedroom and disrupted their care routines; visits by family members or volunteers might have ceased, and delivery of regular community and group activities, including nonpharmacological interventions for behavioral and psychological symptoms of dementia, might have been compromised.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 The implementation of unprecedented public health measures disrupted daily routines and support of people living with dementia, which may have aggravated behavioral and psychological symptoms of dementia. 6 This has led to concerns that antipsychotic drug use may have increased in response to the worsening of symptoms associated with COVID-19 restrictions. 7,8 A few studies have investigated this hypothesis.…”

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confidence: 99%

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Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

et al. 2023

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ImportanceConcerns have been raised that the use of antipsychotic medication for people living with dementia might have increased during the COVID-19 pandemic.ObjectiveTo examine multinational trends in antipsychotic drug prescribing for people living with dementia before and during the COVID-19 pandemic.Design, Setting, and ParticipantsThis multinational network cohort study used electronic health records and claims data from 8 databases in 6 countries (France, Germany, Italy, South Korea, the UK, and the US) for individuals aged 65 years or older between January 1, 2016, and November 30, 2021. Two databases each were included for South Korea and the US.ExposuresThe introduction of population-wide COVID-19 restrictions from April 2020 to the latest available date of each database.Main Outcomes and MeasuresThe main outcomes were yearly and monthly incidence of dementia diagnosis and prevalence of people living with dementia who were prescribed antipsychotic drugs in each database. Interrupted time series analyses were used to quantify changes in prescribing rates before and after the introduction of population-wide COVID-19 restrictions.ResultsA total of 857 238 people with dementia aged 65 years or older (58.0% female) were identified in 2016. Reductions in the incidence of dementia were observed in 7 databases in the early phase of the pandemic (April, May, and June 2020), with the most pronounced reduction observed in 1 of the 2 US databases (rate ratio [RR], 0.30; 95% CI, 0.27-0.32); reductions were also observed in the total number of people with dementia prescribed antipsychotic drugs in France, Italy, South Korea, the UK, and the US. Rates of antipsychotic drug prescribing for people with dementia increased in 6 databases representing all countries. Compared with the corresponding month in 2019, the most pronounced increase in 2020 was observed in May in South Korea (Kangwon National University database) (RR, 2.11; 95% CI, 1.47-3.02) and June in the UK (RR, 1.96; 95% CI, 1.24-3.09). The rates of antipsychotic drug prescribing in these 6 databases remained high in 2021. Interrupted time series analyses revealed immediate increases in the prescribing rate in Italy (RR, 1.31; 95% CI, 1.08-1.58) and in the US Medicare database (RR, 1.43; 95% CI, 1.20-1.71) after the introduction of COVID-19 restrictions.Conclusions and RelevanceThis cohort study found converging evidence that the rate of antipsychotic drug prescribing to people with dementia increased in the initial months of the COVID-19 pandemic in the 6 countries studied and did not decrease to prepandemic levels after the acute phase of the pandemic had ended. These findings suggest that the pandemic disrupted the care of people living with dementia and that the development of intervention strategies is needed to ensure the quality of care.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

et al. 2023

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“…2 In addition, another previous study indicated that community service utilization was positively related to caregiver burden. 3 Therefore, we would like to know the effect of the participant's use of services in this study on depression and anxiety among caregivers.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 pandemic increased the risk of prescribing potentially inappropriate medications to older adults

Suzuki

Shiraishi

Komiya

et al. 2023

Geriatrics Gerontology Int

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“…Coordinators and dyads remain blinded to allocation status until the sequential rollout. The first 6-month intervention period was completed before the Norwegian government adhered to national coronavirus disease 2019 (COVID-19) restrictions (on March 12, 2020), halting the study protocol ( Gedde et al, 2022 ; Vislapuu et al, 2021 ). The data collectors were not able to visit the dyads at home, thus the intervention implementation sequence 2 had to be postponed.…”

Section: Methodsmentioning

confidence: 99%

Feedback System Analysis of a Multicomponent Intervention on Dyads of Home-Dwelling Persons With Dementia and Their Caregivers: Results From the LIVE@Home.Path Trial

Vislapuu,

Patrascu,

Allore

et al. 2024

Innovation in Aging

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Background and Objectives Proper symptom management, informal caregiver support, and service innovation are required to reduce dementia care burden. The objective of this study is to investigate the effect of the multicomponent LIVE (Learning, Innovation, Volunteering, Empowerment) intervention on caregiver experience of the self-perceived care situation, coordinator performance and informal care time. Research Design and Methods We conducted a 24-month multicomponent, stepped-wedge randomized control trial including dyads of people ≥65 years with mild to moderate dementia with minimum weekly contact with their informal caregivers in Norway. The intervention was implemented by municipal coordinators over a 6-month period. This study investigates the first 6-month period (Sept 2019-March 2020) of the trial, due to the COVID-19 pandemic. Primary outcomes are changes in provision of informal care time assessed by Resource Utilization in Dementia Care (RUD) and informal caregiver experience assessed by the Clinical Global Impression of Change (CGIC). We use logistic regression and feedback system analysis to assess the reach of the multicomponent intervention. Results A total of 280 dyads were included at baseline, mean age of the person with dementia was 81.8 years, 62.5% were female. After six months, the feedback system analysis reveals that the caregivers randomized to the intervention period reported improved caregiver situation (CGIG-T: intervention 0.63 (SD 2.4) vs control -0.43 (SD 1.7), p<0.01), even though informal care time for ADL was not reduced (p=0.31). Informal caregivers registered a positive change for the Learning, Innovation and Empowerment components, while no change was found for Volunteer support. Discussion and Implications Findings illustrate the usefulness of dementia care coordinators that provide regular follow-up. We also show that complex intervention studies benefit from applying feedback system analysis. Meeting the needs of persons with dementia and their caregivers is a complex process that requires coordinated input from health services and user communities.

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Cited by 18 publications

References 31 publications

Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

COVID‐19 pandemic increased the risk of prescribing potentially inappropriate medications to older adults

Feedback System Analysis of a Multicomponent Intervention on Dyads of Home-Dwelling Persons With Dementia and Their Caregivers: Results From the LIVE@Home.Path Trial

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