Antipsychotic treatment of community-dwelling and institutionalised patients with dementia in Germany

verfasst von
Philipp Hessmann, Richard Dodel, Erika Baum, Matthias J. Müller, Greta Paschke, Bernhard Kis, Jan Zeidler, Mike Klora, Jens Peter Reese, Monika Balzer-Geldsetzer
Abstract

Objective: A restrictive use of antipsychotic drugs in patients with Alzheimer’s disease (AD) is recommended due to an increased risk of cerebrovascular events and mortality. We hypothesise that the prescription of antipsychotics is associated with the patients’ socio-demographic and clinical status (e.g., dementia severity). Methods: The prescription of antipsychotics was cross-sectionally evaluated in 272 community-dwelling and 123 institutionalised patients with AD across all severity stages of dementia. The patients’ clinical characteristics covered the cognitive status, neuropsychiatric symptoms, daily activities, and quality of life (HrQoL). To determine associations with the use of antipsychotics bivariate and logistic regression analyses were conducted. Results: Totally, 25% of the patients were treated with antipsychotics. significantly less frequently than nursing home inhabitants (15.1% vs. 45.5%). Severely demented patients (MMSE 0–9) received antipsychotics most often (51.5%). Additionally, multiple regression analyses revealed a higher chance of prescription for participants with depressive symptoms (OR 2.3, 95% CI: 1.019–5.160) and those treated by neuropsychiatric specialists (OR 3.4, 95% CI: 1.408–8.328). Conclusions: Further longitudinal studies are required to assess the appropriateness of indications for antipsychotics and the reasons for a higher use in nursing home inhabitants and patients with severe dementia and depression.

Organisationseinheit(en)
Center for Health Economics Research Hannover (CHERH)
Externe Organisation(en)
Georg-August-Universität Göttingen
Philipps-Universität Marburg
Universität Duisburg-Essen
Oberberg Fachkliniken
Justus-Liebig-Universität Gießen
Praxis Alexander Etz
Typ
Artikel
Journal
International Journal of Psychiatry in Clinical Practice
Band
22
Seiten
232-239
Anzahl der Seiten
8
ISSN
1365-1501
Publikationsdatum
03.07.2018
Publikationsstatus
Veröffentlicht
Peer-reviewed
Ja
ASJC Scopus Sachgebiete
Psychiatrie und psychische Gesundheit
Ziele für nachhaltige Entwicklung
SDG 3 – Gute Gesundheit und Wohlergehen
Elektronische Version(en)
https://doi.org/10.1080/13651501.2017.1414269 (Zugang: Geschlossen)