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Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors
BACKGROUND: Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651600/ https://www.ncbi.nlm.nih.gov/pubmed/29061129 http://dx.doi.org/10.1186/s12877-017-0636-8 |
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author | Rios, Sebastian Perlman, Christopher M. Costa, Andrew Heckman, George Hirdes, John P. Mitchell, Lori |
author_facet | Rios, Sebastian Perlman, Christopher M. Costa, Andrew Heckman, George Hirdes, John P. Mitchell, Lori |
author_sort | Rios, Sebastian |
collection | PubMed |
description | BACKGROUND: Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus on factors related to use among those without behavioral or psychotic symptoms. METHODS: Using a retrospective cross-sectional design, this study examines antipsychotic use among adults aged 65 or older with dementia in home care (HC), complex continuing care (CCC), long-term care (LTC), and among alternate level care patients in acute hospitals (ALC). Using clinical data from January 1, 2009 to December 31, 2014, the prevalence of antipsychotic medication use was estimated by the presence of behavioral and psychotic symptoms. Logistic regression was used to identify sector specific factors associated with antipsychotic use in the absence of behavioral and psychotic symptoms. RESULTS: The total prevalence of antipsychotic use among older adults with dementia was 26% in HC, 54% in ALC, 41% in CCC, and 48% in LTC. This prevalence ranged from 38% (HC) to 73% (ALC) for those with both behavioral and psychotic symptoms and from 15% (HC) to 31% (ALC) among those with no symptoms. The regression models identified a number of variables were related to antipsychotic use in the absence of behavior or psychotic symptoms, such as bipolar disorder (OR = 6.63 in CCC; OR = 5.52 in LTC), anxious complaints (OR = 1.54 in LTC to 2.01 in CCC), and wandering (OR = 1.83 in ALC). CONCLUSIONS: Potentially inappropriate use of antipsychotic medications is prevalent among older adults with dementia across health sectors. The variations in prevalence observed from community to facility based care suggests that system issues may exist in appropriately managing persons with dementia. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-017-0636-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5651600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56516002017-10-26 Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors Rios, Sebastian Perlman, Christopher M. Costa, Andrew Heckman, George Hirdes, John P. Mitchell, Lori BMC Geriatr Research Article BACKGROUND: Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus on factors related to use among those without behavioral or psychotic symptoms. METHODS: Using a retrospective cross-sectional design, this study examines antipsychotic use among adults aged 65 or older with dementia in home care (HC), complex continuing care (CCC), long-term care (LTC), and among alternate level care patients in acute hospitals (ALC). Using clinical data from January 1, 2009 to December 31, 2014, the prevalence of antipsychotic medication use was estimated by the presence of behavioral and psychotic symptoms. Logistic regression was used to identify sector specific factors associated with antipsychotic use in the absence of behavioral and psychotic symptoms. RESULTS: The total prevalence of antipsychotic use among older adults with dementia was 26% in HC, 54% in ALC, 41% in CCC, and 48% in LTC. This prevalence ranged from 38% (HC) to 73% (ALC) for those with both behavioral and psychotic symptoms and from 15% (HC) to 31% (ALC) among those with no symptoms. The regression models identified a number of variables were related to antipsychotic use in the absence of behavior or psychotic symptoms, such as bipolar disorder (OR = 6.63 in CCC; OR = 5.52 in LTC), anxious complaints (OR = 1.54 in LTC to 2.01 in CCC), and wandering (OR = 1.83 in ALC). CONCLUSIONS: Potentially inappropriate use of antipsychotic medications is prevalent among older adults with dementia across health sectors. The variations in prevalence observed from community to facility based care suggests that system issues may exist in appropriately managing persons with dementia. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-017-0636-8) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-23 /pmc/articles/PMC5651600/ /pubmed/29061129 http://dx.doi.org/10.1186/s12877-017-0636-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Rios, Sebastian Perlman, Christopher M. Costa, Andrew Heckman, George Hirdes, John P. Mitchell, Lori Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title | Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title_full | Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title_fullStr | Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title_full_unstemmed | Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title_short | Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors |
title_sort | antipsychotics and dementia in canada: a retrospective cross-sectional study of four health sectors |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651600/ https://www.ncbi.nlm.nih.gov/pubmed/29061129 http://dx.doi.org/10.1186/s12877-017-0636-8 |
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