Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia
Objective The aim of this study was to explore the use of first (FGAs) and second generation antipsychotics (SGAs) in older outpatients with schizophrenia and schizoaffective disorder. Factors associated with schizophrenic relapses were also studied. Methods The study sample consisting of 8792 patie...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2013-12, Vol.28 (12), p.1305-1311 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Talaslahti, Tiina Alanen, Hanna-Mari Hakko, Helinä Isohanni, Matti Häkkinen, Unto Leinonen, Esa |
| description | Objective
The aim of this study was to explore the use of first (FGAs) and second generation antipsychotics (SGAs) in older outpatients with schizophrenia and schizoaffective disorder. Factors associated with schizophrenic relapses were also studied.
Methods
The study sample consisting of 8792 patients aged 64 years or more was collected from Finnish nationwide registers. The register data on the use of FGAs and SGAs were followed up between 1998 and 2003. Factors associated with psychiatric hospitalization in 1999 indicating relapse were studied using logistic regression analysis.
Results
The use of SGAs increased from 2.8% to 12.4%, and the use of FGAs decreased from 57.5% to 39.4%. The use of a combination of SGAs and FGAs increased from 4.0% to 8.5%. The proportion of those who did not buy any antipsychotics varied between 35.8% and 39.7%. The number of patients hospitalized on psychiatric wards within a year (1999; relapsed) was 8.8%. Factors independently associated with relapse were use of combined FGAs and SGAs [odds ratio (OR) 1.70, p = 0.001] and use of antidepressants (OR 1.27, p = 0.019). Diagnosis of cardiovascular disease was negatively associated with risk of schizophrenic relapse (OR 0.84, p = 0.040).
Conclusion
The use of SGAs increased while the use of FGAs decreased in older outpatients with schizophrenia. Almost 40% of the study sample did not use any antipsychotic medication. The 1‐year relapse rate was 8.8%. Several factors, such as combined use of FGAs and SGAs, or antidepressants, were associated with schizophrenic relapse, whereas cardiovascular disease showed a negative association with the relapse. Copyright © 2013 John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/gps.3962 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1492617914</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1492617914</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4502-3df34c130193b3f7ab3d55dd22c2c3b988710e4c8e986dee165818efee83645f3</originalsourceid><addsrcrecordid>eNqN0V1r1TAYB_AgDnc2BT-BFETwpjMvzUsv5aBHt6EDFb0y5KRP12w9bZenZTt-enO2uoEgeBVIfnn-CX9CnjN6xCjlb84HPBKl4o_IgtGyzBlT6jFZUGNkrrig--QA8YLSdMbME7LPhZSmNGpBfi4b151DFrrMdWMYcOubfgw-m9Cl7cGNI8TdWZXFgJdZX2cRWjfg7ZW-rSDuUIBuxOw6jE2Gvgm_-qGJ0AX3lOzVrkV4Nq-H5Nv7d1-XH_LTz6uPy7enuS8k5bmoalF4JigrxVrU2q1FJWVVce65F-vSGM0oFN5AenQFwJQ0zEANYIQqZC0Oyeu7uUPsrybA0W4Cemhb10E_oWVFyRXTJSv-gyarpdIq0Zd_0Yt-il36SFIyRXOq-cNAH3vECLUdYti4uLWM2l09NtVjd_Uk-mIeOK03UN3DP30k8GoGDr1r6-g6H_DBaaPLFJxcfueuQwvbfwba1dmXOXj2AUe4ufcuXlqlhZb2-6eVLdjJ8Y-zYmWF-A15HLRA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1458362072</pqid></control><display><type>article</type><title>Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Talaslahti, Tiina ; Alanen, Hanna-Mari ; Hakko, Helinä ; Isohanni, Matti ; Häkkinen, Unto ; Leinonen, Esa</creator><creatorcontrib>Talaslahti, Tiina ; Alanen, Hanna-Mari ; Hakko, Helinä ; Isohanni, Matti ; Häkkinen, Unto ; Leinonen, Esa</creatorcontrib><description>Objective
The aim of this study was to explore the use of first (FGAs) and second generation antipsychotics (SGAs) in older outpatients with schizophrenia and schizoaffective disorder. Factors associated with schizophrenic relapses were also studied.
Methods
The study sample consisting of 8792 patients aged 64 years or more was collected from Finnish nationwide registers. The register data on the use of FGAs and SGAs were followed up between 1998 and 2003. Factors associated with psychiatric hospitalization in 1999 indicating relapse were studied using logistic regression analysis.
Results
The use of SGAs increased from 2.8% to 12.4%, and the use of FGAs decreased from 57.5% to 39.4%. The use of a combination of SGAs and FGAs increased from 4.0% to 8.5%. The proportion of those who did not buy any antipsychotics varied between 35.8% and 39.7%. The number of patients hospitalized on psychiatric wards within a year (1999; relapsed) was 8.8%. Factors independently associated with relapse were use of combined FGAs and SGAs [odds ratio (OR) 1.70, p = 0.001] and use of antidepressants (OR 1.27, p = 0.019). Diagnosis of cardiovascular disease was negatively associated with risk of schizophrenic relapse (OR 0.84, p = 0.040).
Conclusion
The use of SGAs increased while the use of FGAs decreased in older outpatients with schizophrenia. Almost 40% of the study sample did not use any antipsychotic medication. The 1‐year relapse rate was 8.8%. Several factors, such as combined use of FGAs and SGAs, or antidepressants, were associated with schizophrenic relapse, whereas cardiovascular disease showed a negative association with the relapse. Copyright © 2013 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.3962</identifier><identifier>PMID: 23558986</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>Hove: Blackwell Publishing Ltd</publisher><subject>Adult and adolescent clinical studies ; Aged ; Aged, 80 and over ; Antipsychotic Agents - therapeutic use ; antipsychotics ; Biological and medical sciences ; Drug use ; Female ; Finland ; General aspects ; Geriatric psychiatry ; Geriatrics ; Hospitalization ; Humans ; Logistic Models ; Male ; Medical sciences ; Medication Adherence ; older patients ; Older people ; Prescription drugs ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychoses ; Recurrence ; Regression analysis ; relapse ; Risk Factors ; Schizophrenia ; Schizophrenia - drug therapy</subject><ispartof>International journal of geriatric psychiatry, 2013-12, Vol.28 (12), p.1305-1311</ispartof><rights>Copyright © 2013 John Wiley & Sons, Ltd.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright John Wiley and Sons, Limited Dec 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4502-3df34c130193b3f7ab3d55dd22c2c3b988710e4c8e986dee165818efee83645f3</citedby><cites>FETCH-LOGICAL-c4502-3df34c130193b3f7ab3d55dd22c2c3b988710e4c8e986dee165818efee83645f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.3962$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.3962$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27879583$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23558986$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Talaslahti, Tiina</creatorcontrib><creatorcontrib>Alanen, Hanna-Mari</creatorcontrib><creatorcontrib>Hakko, Helinä</creatorcontrib><creatorcontrib>Isohanni, Matti</creatorcontrib><creatorcontrib>Häkkinen, Unto</creatorcontrib><creatorcontrib>Leinonen, Esa</creatorcontrib><title>Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia</title><title>International journal of geriatric psychiatry</title><addtitle>Int J Geriatr Psychiatry</addtitle><description>Objective
The aim of this study was to explore the use of first (FGAs) and second generation antipsychotics (SGAs) in older outpatients with schizophrenia and schizoaffective disorder. Factors associated with schizophrenic relapses were also studied.
Methods
The study sample consisting of 8792 patients aged 64 years or more was collected from Finnish nationwide registers. The register data on the use of FGAs and SGAs were followed up between 1998 and 2003. Factors associated with psychiatric hospitalization in 1999 indicating relapse were studied using logistic regression analysis.
Results
The use of SGAs increased from 2.8% to 12.4%, and the use of FGAs decreased from 57.5% to 39.4%. The use of a combination of SGAs and FGAs increased from 4.0% to 8.5%. The proportion of those who did not buy any antipsychotics varied between 35.8% and 39.7%. The number of patients hospitalized on psychiatric wards within a year (1999; relapsed) was 8.8%. Factors independently associated with relapse were use of combined FGAs and SGAs [odds ratio (OR) 1.70, p = 0.001] and use of antidepressants (OR 1.27, p = 0.019). Diagnosis of cardiovascular disease was negatively associated with risk of schizophrenic relapse (OR 0.84, p = 0.040).
Conclusion
The use of SGAs increased while the use of FGAs decreased in older outpatients with schizophrenia. Almost 40% of the study sample did not use any antipsychotic medication. The 1‐year relapse rate was 8.8%. Several factors, such as combined use of FGAs and SGAs, or antidepressants, were associated with schizophrenic relapse, whereas cardiovascular disease showed a negative association with the relapse. Copyright © 2013 John Wiley & Sons, Ltd.</description><subject>Adult and adolescent clinical studies</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>antipsychotics</subject><subject>Biological and medical sciences</subject><subject>Drug use</subject><subject>Female</subject><subject>Finland</subject><subject>General aspects</subject><subject>Geriatric psychiatry</subject><subject>Geriatrics</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Adherence</subject><subject>older patients</subject><subject>Older people</subject><subject>Prescription drugs</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychoses</subject><subject>Recurrence</subject><subject>Regression analysis</subject><subject>relapse</subject><subject>Risk Factors</subject><subject>Schizophrenia</subject><subject>Schizophrenia - drug therapy</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0V1r1TAYB_AgDnc2BT-BFETwpjMvzUsv5aBHt6EDFb0y5KRP12w9bZenZTt-enO2uoEgeBVIfnn-CX9CnjN6xCjlb84HPBKl4o_IgtGyzBlT6jFZUGNkrrig--QA8YLSdMbME7LPhZSmNGpBfi4b151DFrrMdWMYcOubfgw-m9Cl7cGNI8TdWZXFgJdZX2cRWjfg7ZW-rSDuUIBuxOw6jE2Gvgm_-qGJ0AX3lOzVrkV4Nq-H5Nv7d1-XH_LTz6uPy7enuS8k5bmoalF4JigrxVrU2q1FJWVVce65F-vSGM0oFN5AenQFwJQ0zEANYIQqZC0Oyeu7uUPsrybA0W4Cemhb10E_oWVFyRXTJSv-gyarpdIq0Zd_0Yt-il36SFIyRXOq-cNAH3vECLUdYti4uLWM2l09NtVjd_Uk-mIeOK03UN3DP30k8GoGDr1r6-g6H_DBaaPLFJxcfueuQwvbfwba1dmXOXj2AUe4ufcuXlqlhZb2-6eVLdjJ8Y-zYmWF-A15HLRA</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Talaslahti, Tiina</creator><creator>Alanen, Hanna-Mari</creator><creator>Hakko, Helinä</creator><creator>Isohanni, Matti</creator><creator>Häkkinen, Unto</creator><creator>Leinonen, Esa</creator><general>Blackwell Publishing Ltd</general><general>Psychology Press</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201312</creationdate><title>Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia</title><author>Talaslahti, Tiina ; Alanen, Hanna-Mari ; Hakko, Helinä ; Isohanni, Matti ; Häkkinen, Unto ; Leinonen, Esa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4502-3df34c130193b3f7ab3d55dd22c2c3b988710e4c8e986dee165818efee83645f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>antipsychotics</topic><topic>Biological and medical sciences</topic><topic>Drug use</topic><topic>Female</topic><topic>Finland</topic><topic>General aspects</topic><topic>Geriatric psychiatry</topic><topic>Geriatrics</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication Adherence</topic><topic>older patients</topic><topic>Older people</topic><topic>Prescription drugs</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychoses</topic><topic>Recurrence</topic><topic>Regression analysis</topic><topic>relapse</topic><topic>Risk Factors</topic><topic>Schizophrenia</topic><topic>Schizophrenia - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Talaslahti, Tiina</creatorcontrib><creatorcontrib>Alanen, Hanna-Mari</creatorcontrib><creatorcontrib>Hakko, Helinä</creatorcontrib><creatorcontrib>Isohanni, Matti</creatorcontrib><creatorcontrib>Häkkinen, Unto</creatorcontrib><creatorcontrib>Leinonen, Esa</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Talaslahti, Tiina</au><au>Alanen, Hanna-Mari</au><au>Hakko, Helinä</au><au>Isohanni, Matti</au><au>Häkkinen, Unto</au><au>Leinonen, Esa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int J Geriatr Psychiatry</addtitle><date>2013-12</date><risdate>2013</risdate><volume>28</volume><issue>12</issue><spage>1305</spage><epage>1311</epage><pages>1305-1311</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Objective
The aim of this study was to explore the use of first (FGAs) and second generation antipsychotics (SGAs) in older outpatients with schizophrenia and schizoaffective disorder. Factors associated with schizophrenic relapses were also studied.
Methods
The study sample consisting of 8792 patients aged 64 years or more was collected from Finnish nationwide registers. The register data on the use of FGAs and SGAs were followed up between 1998 and 2003. Factors associated with psychiatric hospitalization in 1999 indicating relapse were studied using logistic regression analysis.
Results
The use of SGAs increased from 2.8% to 12.4%, and the use of FGAs decreased from 57.5% to 39.4%. The use of a combination of SGAs and FGAs increased from 4.0% to 8.5%. The proportion of those who did not buy any antipsychotics varied between 35.8% and 39.7%. The number of patients hospitalized on psychiatric wards within a year (1999; relapsed) was 8.8%. Factors independently associated with relapse were use of combined FGAs and SGAs [odds ratio (OR) 1.70, p = 0.001] and use of antidepressants (OR 1.27, p = 0.019). Diagnosis of cardiovascular disease was negatively associated with risk of schizophrenic relapse (OR 0.84, p = 0.040).
Conclusion
The use of SGAs increased while the use of FGAs decreased in older outpatients with schizophrenia. Almost 40% of the study sample did not use any antipsychotic medication. The 1‐year relapse rate was 8.8%. Several factors, such as combined use of FGAs and SGAs, or antidepressants, were associated with schizophrenic relapse, whereas cardiovascular disease showed a negative association with the relapse. Copyright © 2013 John Wiley & Sons, Ltd.</abstract><cop>Hove</cop><pub>Blackwell Publishing Ltd</pub><pmid>23558986</pmid><doi>10.1002/gps.3962</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult and adolescent clinical studies Aged Aged, 80 and over Antipsychotic Agents - therapeutic use antipsychotics Biological and medical sciences Drug use Female Finland General aspects Geriatric psychiatry Geriatrics Hospitalization Humans Logistic Models Male Medical sciences Medication Adherence older patients Older people Prescription drugs Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Recurrence Regression analysis relapse Risk Factors Schizophrenia Schizophrenia - drug therapy |
| title | Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia |
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