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Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom

PURPOSE: To test hypotheses that minority ethnic people with dementia in the UK receive fewer anti-dementia drugs and more psychotropic and anticholinergic drugs associated with harms. PATIENTS AND METHODS: We analyzed UK primary care electronic health records from The Health Improvement Network (TH...

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Autores principales: Jones, Mary Elizabeth, Petersen, Irene, Walters, Kate, Bhanu, Cini, Manthorpe, Jill, Raine, Rosalind, Mukadam, Naaheed, Cooper, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980848/
https://www.ncbi.nlm.nih.gov/pubmed/32021472
http://dx.doi.org/10.2147/CLEP.S222126
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author Jones, Mary Elizabeth
Petersen, Irene
Walters, Kate
Bhanu, Cini
Manthorpe, Jill
Raine, Rosalind
Mukadam, Naaheed
Cooper, Claudia
author_facet Jones, Mary Elizabeth
Petersen, Irene
Walters, Kate
Bhanu, Cini
Manthorpe, Jill
Raine, Rosalind
Mukadam, Naaheed
Cooper, Claudia
author_sort Jones, Mary Elizabeth
collection PubMed
description PURPOSE: To test hypotheses that minority ethnic people with dementia in the UK receive fewer anti-dementia drugs and more psychotropic and anticholinergic drugs associated with harms. PATIENTS AND METHODS: We analyzed UK primary care electronic health records from The Health Improvement Network (THIN) database (2014–2016), comparing psychotropic drug prescribing initiation and duration between people with dementia from White, Black, and Asian ethnic groups. We repeated analyses in people (aged 50+) without dementia, to explore whether any differences found reflected prescribing patterns in the general older population, or were specific to dementia. RESULTS: We included 53,718 people with and 1,648,889 people without dementia. Among people with dementia, compared to White ethnic groups, Asian people were less likely to be prescribed anti-dementia drugs when they were potentially indicated (adjusted prevalence rate ratio 0.86 (95% Confidence Interval 0.76–0.98)), and received them for on average 15 days/year less. Compared to White groups, Asian and Black individuals with dementia were no more likely to take an antipsychotic drug, but those that had were prescribed them for 17 and 27 days/year more, respectively (190.8 (179.6–199.1) and 200.7 (191.1–206.5) days). Black people were less likely to be prescribed anxiolytics/hypnotics (0.60 (0.44–0.8)), but the duration these drugs were prescribed was similar across ethnic groups. Asian people were more likely to be prescribed anticholinergic drugs (1.43 (1.19–1.73)), in analyses unadjusted for cardiovascular comorbidities. Among people without dementia, those in the Asian and Black ethnic groups were less likely to be prescribed psychotropic drugs, relative to people from White groups. CONCLUSION: Among people with dementia, Asian groups received less potentially beneficial symptomatic treatments, and Asian and Black groups were prescribed antipsychotic drugs for longer than White ethnic groups. Our findings may indicate care inequalities.
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spelling pubmed-69808482020-02-04 Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom Jones, Mary Elizabeth Petersen, Irene Walters, Kate Bhanu, Cini Manthorpe, Jill Raine, Rosalind Mukadam, Naaheed Cooper, Claudia Clin Epidemiol Original Research PURPOSE: To test hypotheses that minority ethnic people with dementia in the UK receive fewer anti-dementia drugs and more psychotropic and anticholinergic drugs associated with harms. PATIENTS AND METHODS: We analyzed UK primary care electronic health records from The Health Improvement Network (THIN) database (2014–2016), comparing psychotropic drug prescribing initiation and duration between people with dementia from White, Black, and Asian ethnic groups. We repeated analyses in people (aged 50+) without dementia, to explore whether any differences found reflected prescribing patterns in the general older population, or were specific to dementia. RESULTS: We included 53,718 people with and 1,648,889 people without dementia. Among people with dementia, compared to White ethnic groups, Asian people were less likely to be prescribed anti-dementia drugs when they were potentially indicated (adjusted prevalence rate ratio 0.86 (95% Confidence Interval 0.76–0.98)), and received them for on average 15 days/year less. Compared to White groups, Asian and Black individuals with dementia were no more likely to take an antipsychotic drug, but those that had were prescribed them for 17 and 27 days/year more, respectively (190.8 (179.6–199.1) and 200.7 (191.1–206.5) days). Black people were less likely to be prescribed anxiolytics/hypnotics (0.60 (0.44–0.8)), but the duration these drugs were prescribed was similar across ethnic groups. Asian people were more likely to be prescribed anticholinergic drugs (1.43 (1.19–1.73)), in analyses unadjusted for cardiovascular comorbidities. Among people without dementia, those in the Asian and Black ethnic groups were less likely to be prescribed psychotropic drugs, relative to people from White groups. CONCLUSION: Among people with dementia, Asian groups received less potentially beneficial symptomatic treatments, and Asian and Black groups were prescribed antipsychotic drugs for longer than White ethnic groups. Our findings may indicate care inequalities. Dove 2020-01-20 /pmc/articles/PMC6980848/ /pubmed/32021472 http://dx.doi.org/10.2147/CLEP.S222126 Text en © 2020 Jones et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Jones, Mary Elizabeth
Petersen, Irene
Walters, Kate
Bhanu, Cini
Manthorpe, Jill
Raine, Rosalind
Mukadam, Naaheed
Cooper, Claudia
Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title_full Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title_fullStr Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title_full_unstemmed Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title_short Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom
title_sort differences in psychotropic drug prescribing between ethnic groups of people with dementia in the united kingdom
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980848/
https://www.ncbi.nlm.nih.gov/pubmed/32021472
http://dx.doi.org/10.2147/CLEP.S222126
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