Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia: A Nationwide Study
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Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia : A Nationwide Study. / Zakarias, Johanne Købstrup; Jensen-Dahm, Christina; Nørgaard, Ane; Stevnsborg, Lea; Gasse, Christiane; Andersen, Bodil Gramkow; Jacobsen, Søren; Waldorff, Frans Boch; Moos, Torben; Waldemar, Gunhild.
In: Journal of Alzheimer's Disease, Vol. 54, No. 3, 04.10.2016, p. 1183-1192.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia
T2 - A Nationwide Study
AU - Zakarias, Johanne Købstrup
AU - Jensen-Dahm, Christina
AU - Nørgaard, Ane
AU - Stevnsborg, Lea
AU - Gasse, Christiane
AU - Andersen, Bodil Gramkow
AU - Jacobsen, Søren
AU - Waldorff, Frans Boch
AU - Moos, Torben
AU - Waldemar, Gunhild
PY - 2016/10/4
Y1 - 2016/10/4
N2 - BACKGROUND: Use of antipsychotics in elderly patients with dementia has decreased in the past decade due to safety regulations; however use is still high. Geographical variation may indicate discrepancies in clinical practice and lack of adherence to evidence-based guidelines for the management of behavioral symptoms.OBJECTIVE: To investigate potential geographical variances in use of antipsychotic drugs in dementia care.METHODS: A registry-based cross-sectional study in the entire elderly population of Denmark (≥65 years) conducted in 2012. Data included place of residence, prescriptions filled, and hospital discharge diagnoses. Antipsychotic drug use among elderly with (n = 34,536) and without (n = 931,203) a dementia diagnosis was compared across the five regions and 98 municipalities in Denmark, adjusted for age and sex.RESULTS: In 2012, the national prevalence of antipsychotic drug use was 20.7% for elderly patients with dementia, with a national incidence of 3.9%. The prevalence ranged from 17.0% to 23.3% in the five regions and from 7.5% to 33.1% in the 98 municipalities, demonstrating an over four-fold difference.CONCLUSION: The observed geographical variation was more pronounced at municipal level as compared to regional level, suggesting that the variation may be related to variances in clinical practice in primary care. This study highlights an urgent need for further educating professional carers and physicians to guide non-pharmacological as well as pharmacological management of neuropsychiatric symptoms in elderly patients with dementia.
AB - BACKGROUND: Use of antipsychotics in elderly patients with dementia has decreased in the past decade due to safety regulations; however use is still high. Geographical variation may indicate discrepancies in clinical practice and lack of adherence to evidence-based guidelines for the management of behavioral symptoms.OBJECTIVE: To investigate potential geographical variances in use of antipsychotic drugs in dementia care.METHODS: A registry-based cross-sectional study in the entire elderly population of Denmark (≥65 years) conducted in 2012. Data included place of residence, prescriptions filled, and hospital discharge diagnoses. Antipsychotic drug use among elderly with (n = 34,536) and without (n = 931,203) a dementia diagnosis was compared across the five regions and 98 municipalities in Denmark, adjusted for age and sex.RESULTS: In 2012, the national prevalence of antipsychotic drug use was 20.7% for elderly patients with dementia, with a national incidence of 3.9%. The prevalence ranged from 17.0% to 23.3% in the five regions and from 7.5% to 33.1% in the 98 municipalities, demonstrating an over four-fold difference.CONCLUSION: The observed geographical variation was more pronounced at municipal level as compared to regional level, suggesting that the variation may be related to variances in clinical practice in primary care. This study highlights an urgent need for further educating professional carers and physicians to guide non-pharmacological as well as pharmacological management of neuropsychiatric symptoms in elderly patients with dementia.
U2 - 10.3233/JAD-160485
DO - 10.3233/JAD-160485
M3 - Journal article
C2 - 27567863
VL - 54
SP - 1183
EP - 1192
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 3
ER -
ID: 171796420