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

authored by

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.

Organisation(s)

Center for Health Economics Research Hannover (CHERH)

External Organisation(s)

University of Göttingen
Philipps-Universität Marburg
University of Duisburg-Essen
Oberberg Fachkliniken
Justus Liebig University Giessen
Praxis Alexander Etz

Type

Article

Journal

International Journal of Psychiatry in Clinical Practice

Volume

22

Pages

232-239

No. of pages

8

ISSN

1365-1501

Publication date

03.07.2018

Publication status

Published

Peer reviewed

Yes

ASJC Scopus subject areas

Psychiatry and Mental health

Sustainable Development Goals

SDG 3 - Good Health and Well-being

Electronic version(s)

https://doi.org/10.1080/13651501.2017.1414269 (Access: Closed)