The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study
Background Antipsychotic (AP) drugs are commonly used to manage the behavioural symptoms of dementia. Nevertheless, international (i.e. the European Medicines Agency in Europe) and national (i.e. the Medicines and Healthcare products Regulatory Agency in the UK and the Italian Drug Agency) regulator...
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| Veröffentlicht in: | CNS drugs 2016-11, Vol.30 (11), p.1097-1109 |
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| creator | Sultana, Janet Fontana, Andrea Giorgianni, Francesco Pasqua, Alessandro Cricelli, Claudio Spina, Edoardo Gambassi, Giovanni Ivanovic, Jelena Ferrajolo, Carmen Molokhia, Mariam Ballard, Clive Sharp, Samantha Sturkenboom, Miriam Trifirò, Gianluca |
| description | Background
Antipsychotic (AP) drugs are commonly used to manage the behavioural symptoms of dementia. Nevertheless, international (i.e. the European Medicines Agency in Europe) and national (i.e. the Medicines and Healthcare products Regulatory Agency in the UK and the Italian Drug Agency) regulatory agencies issued safety warnings against AP use in dementia in 2004 and 2009.
Objective
The aim of this study is to investigate the short- and long-term impact of safety warnings on the use of APs in UK and Italian persons with dementia using two nationwide databases: The Health Improvement Network (THIN) from the UK and the Health Search Database-Cegedim-Strategic Data-Longitudinal Patient Database (HSD-CSD-LPD) from Italy.
Methods
We calculated the overall quarterly prevalence of AP use by class and by individual drug in persons with dementia aged ≥65 years and used generalized linear models to explore the effect of the safety warnings.
Results
We identified 58,497 and 10,857 individuals aged ≥65 years with dementia from the THIN and HSD-CSD-LPD databases, respectively, over the period 2000–2012. After the 2004 warnings, the use of atypical APs decreased, whereas the use of conventional APs increased, in Italy and the UK until 2009. However, the trend for APs individually showed that the use of risperidone/olanzapine decreased, whereas the use of quetiapine increased in both countries. After the 2009 warnings (until 2012), the use of atypical and conventional APs decreased in the UK (from 11 to 9 and 5 to 3 %, respectively), but such use increased in Italy (from 11 to 18 and 9 to 14 %, respectively).
Conclusion
The 2004 warnings led to a reduction in the use of olanzapine and risperidone and increased the use of quetiapine/conventional APs in both countries. From 2009, the use of APs decreased in persons with dementia in the UK but not in Italy. Possible reasons for the difference in AP use between the two countries include a more proactive approach towards reducing the use of APs in the UK than in Italy. |
| doi_str_mv | 10.1007/s40263-016-0366-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1837326923</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826721538</sourcerecordid><originalsourceid>FETCH-LOGICAL-c448t-695c1c5330241542d2d3fd0957b2f0938a494e2dfe0620dd2c46074552e9e9ef3</originalsourceid><addsrcrecordid>eNqN0U9rFDEYBvBBFFurH8CLBLx4Gc2_SWa8re1WiwUX2uJxyCZvdlNmkjXJINOP4qdt1q0igiA5JJDf84bwVNVLgt8SjOW7xDEVrMZE1JgJUd89qo4JkV1NOsYf_zzTWmIuj6pnKd1ijHlhT6sjKjlllIjj6sf1FtDSWtAZBYuulIU8o68qeuc3CQWPFj67XZr1NmSn0VmcNmgVIeno1oUg59FyMBCHGa0gpuAT-u7yFp3BCCWp9iCXN268y2DQ55IxYUTKG3SR1TC_Rwu0CrtpUNkFX39QqairPJn5efXEqiHBi4f9pLo5X16ffqovv3y8OF1c1przNteiazTRDWOYctJwaqhh1uCukWtqccdaxTsO1FjAgmJjqOYCS940FLqyLDup3hzm7mL4NkHK_eiShmFQHsKUetIyyajoKPsPSoWkpGFtoa__ordhir58pCiBBWvbDhdFDkrHkFIE2--iG1Wce4L7fcf9oeO-dNzvO-7vSubVw-RpPYL5nfhVagH0AFK58huIfzz9z6n32lGxbA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1860638890</pqid></control><display><type>article</type><title>The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sultana, Janet ; Fontana, Andrea ; Giorgianni, Francesco ; Pasqua, Alessandro ; Cricelli, Claudio ; Spina, Edoardo ; Gambassi, Giovanni ; Ivanovic, Jelena ; Ferrajolo, Carmen ; Molokhia, Mariam ; Ballard, Clive ; Sharp, Samantha ; Sturkenboom, Miriam ; Trifirò, Gianluca</creator><creatorcontrib>Sultana, Janet ; Fontana, Andrea ; Giorgianni, Francesco ; Pasqua, Alessandro ; Cricelli, Claudio ; Spina, Edoardo ; Gambassi, Giovanni ; Ivanovic, Jelena ; Ferrajolo, Carmen ; Molokhia, Mariam ; Ballard, Clive ; Sharp, Samantha ; Sturkenboom, Miriam ; Trifirò, Gianluca</creatorcontrib><description>Background
Antipsychotic (AP) drugs are commonly used to manage the behavioural symptoms of dementia. Nevertheless, international (i.e. the European Medicines Agency in Europe) and national (i.e. the Medicines and Healthcare products Regulatory Agency in the UK and the Italian Drug Agency) regulatory agencies issued safety warnings against AP use in dementia in 2004 and 2009.
Objective
The aim of this study is to investigate the short- and long-term impact of safety warnings on the use of APs in UK and Italian persons with dementia using two nationwide databases: The Health Improvement Network (THIN) from the UK and the Health Search Database-Cegedim-Strategic Data-Longitudinal Patient Database (HSD-CSD-LPD) from Italy.
Methods
We calculated the overall quarterly prevalence of AP use by class and by individual drug in persons with dementia aged ≥65 years and used generalized linear models to explore the effect of the safety warnings.
Results
We identified 58,497 and 10,857 individuals aged ≥65 years with dementia from the THIN and HSD-CSD-LPD databases, respectively, over the period 2000–2012. After the 2004 warnings, the use of atypical APs decreased, whereas the use of conventional APs increased, in Italy and the UK until 2009. However, the trend for APs individually showed that the use of risperidone/olanzapine decreased, whereas the use of quetiapine increased in both countries. After the 2009 warnings (until 2012), the use of atypical and conventional APs decreased in the UK (from 11 to 9 and 5 to 3 %, respectively), but such use increased in Italy (from 11 to 18 and 9 to 14 %, respectively).
Conclusion
The 2004 warnings led to a reduction in the use of olanzapine and risperidone and increased the use of quetiapine/conventional APs in both countries. From 2009, the use of APs decreased in persons with dementia in the UK but not in Italy. Possible reasons for the difference in AP use between the two countries include a more proactive approach towards reducing the use of APs in the UK than in Italy.</description><identifier>ISSN: 1172-7047</identifier><identifier>EISSN: 1179-1934</identifier><identifier>DOI: 10.1007/s40263-016-0366-z</identifier><identifier>PMID: 27423216</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Audits ; Benzodiazepines - adverse effects ; Benzodiazepines - therapeutic use ; Data analysis ; Databases, Factual ; Dementia ; Dementia - drug therapy ; Drug Prescriptions ; Female ; Funding ; Humans ; Initiatives ; Italy ; Male ; Medicine ; Medicine & Public Health ; Mortality ; Neurology ; Neurosciences ; Older people ; Original Research Article ; Patients ; Pharmacotherapy ; Population ; Practice Patterns, Physicians ; Psychiatry ; Psychopharmacology ; Psychotropic drugs ; Retrospective Studies ; Risperidone - adverse effects ; Risperidone - therapeutic use ; Studies ; Trends ; United Kingdom</subject><ispartof>CNS drugs, 2016-11, Vol.30 (11), p.1097-1109</ispartof><rights>Springer International Publishing Switzerland 2016</rights><rights>Copyright Springer Science & Business Media Nov 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-695c1c5330241542d2d3fd0957b2f0938a494e2dfe0620dd2c46074552e9e9ef3</citedby><cites>FETCH-LOGICAL-c448t-695c1c5330241542d2d3fd0957b2f0938a494e2dfe0620dd2c46074552e9e9ef3</cites><orcidid>0000-0001-9622-169X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40263-016-0366-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40263-016-0366-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27423216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sultana, Janet</creatorcontrib><creatorcontrib>Fontana, Andrea</creatorcontrib><creatorcontrib>Giorgianni, Francesco</creatorcontrib><creatorcontrib>Pasqua, Alessandro</creatorcontrib><creatorcontrib>Cricelli, Claudio</creatorcontrib><creatorcontrib>Spina, Edoardo</creatorcontrib><creatorcontrib>Gambassi, Giovanni</creatorcontrib><creatorcontrib>Ivanovic, Jelena</creatorcontrib><creatorcontrib>Ferrajolo, Carmen</creatorcontrib><creatorcontrib>Molokhia, Mariam</creatorcontrib><creatorcontrib>Ballard, Clive</creatorcontrib><creatorcontrib>Sharp, Samantha</creatorcontrib><creatorcontrib>Sturkenboom, Miriam</creatorcontrib><creatorcontrib>Trifirò, Gianluca</creatorcontrib><title>The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study</title><title>CNS drugs</title><addtitle>CNS Drugs</addtitle><addtitle>CNS Drugs</addtitle><description>Background
Antipsychotic (AP) drugs are commonly used to manage the behavioural symptoms of dementia. Nevertheless, international (i.e. the European Medicines Agency in Europe) and national (i.e. the Medicines and Healthcare products Regulatory Agency in the UK and the Italian Drug Agency) regulatory agencies issued safety warnings against AP use in dementia in 2004 and 2009.
Objective
The aim of this study is to investigate the short- and long-term impact of safety warnings on the use of APs in UK and Italian persons with dementia using two nationwide databases: The Health Improvement Network (THIN) from the UK and the Health Search Database-Cegedim-Strategic Data-Longitudinal Patient Database (HSD-CSD-LPD) from Italy.
Methods
We calculated the overall quarterly prevalence of AP use by class and by individual drug in persons with dementia aged ≥65 years and used generalized linear models to explore the effect of the safety warnings.
Results
We identified 58,497 and 10,857 individuals aged ≥65 years with dementia from the THIN and HSD-CSD-LPD databases, respectively, over the period 2000–2012. After the 2004 warnings, the use of atypical APs decreased, whereas the use of conventional APs increased, in Italy and the UK until 2009. However, the trend for APs individually showed that the use of risperidone/olanzapine decreased, whereas the use of quetiapine increased in both countries. After the 2009 warnings (until 2012), the use of atypical and conventional APs decreased in the UK (from 11 to 9 and 5 to 3 %, respectively), but such use increased in Italy (from 11 to 18 and 9 to 14 %, respectively).
Conclusion
The 2004 warnings led to a reduction in the use of olanzapine and risperidone and increased the use of quetiapine/conventional APs in both countries. From 2009, the use of APs decreased in persons with dementia in the UK but not in Italy. Possible reasons for the difference in AP use between the two countries include a more proactive approach towards reducing the use of APs in the UK than in Italy.</description><subject>Aged</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Audits</subject><subject>Benzodiazepines - adverse effects</subject><subject>Benzodiazepines - therapeutic use</subject><subject>Data analysis</subject><subject>Databases, Factual</subject><subject>Dementia</subject><subject>Dementia - drug therapy</subject><subject>Drug Prescriptions</subject><subject>Female</subject><subject>Funding</subject><subject>Humans</subject><subject>Initiatives</subject><subject>Italy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Older people</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmacotherapy</subject><subject>Population</subject><subject>Practice Patterns, Physicians</subject><subject>Psychiatry</subject><subject>Psychopharmacology</subject><subject>Psychotropic drugs</subject><subject>Retrospective Studies</subject><subject>Risperidone - adverse effects</subject><subject>Risperidone - therapeutic use</subject><subject>Studies</subject><subject>Trends</subject><subject>United Kingdom</subject><issn>1172-7047</issn><issn>1179-1934</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqN0U9rFDEYBvBBFFurH8CLBLx4Gc2_SWa8re1WiwUX2uJxyCZvdlNmkjXJINOP4qdt1q0igiA5JJDf84bwVNVLgt8SjOW7xDEVrMZE1JgJUd89qo4JkV1NOsYf_zzTWmIuj6pnKd1ijHlhT6sjKjlllIjj6sf1FtDSWtAZBYuulIU8o68qeuc3CQWPFj67XZr1NmSn0VmcNmgVIeno1oUg59FyMBCHGa0gpuAT-u7yFp3BCCWp9iCXN268y2DQ55IxYUTKG3SR1TC_Rwu0CrtpUNkFX39QqairPJn5efXEqiHBi4f9pLo5X16ffqovv3y8OF1c1przNteiazTRDWOYctJwaqhh1uCukWtqccdaxTsO1FjAgmJjqOYCS940FLqyLDup3hzm7mL4NkHK_eiShmFQHsKUetIyyajoKPsPSoWkpGFtoa__ordhir58pCiBBWvbDhdFDkrHkFIE2--iG1Wce4L7fcf9oeO-dNzvO-7vSubVw-RpPYL5nfhVagH0AFK58huIfzz9z6n32lGxbA</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Sultana, Janet</creator><creator>Fontana, Andrea</creator><creator>Giorgianni, Francesco</creator><creator>Pasqua, Alessandro</creator><creator>Cricelli, Claudio</creator><creator>Spina, Edoardo</creator><creator>Gambassi, Giovanni</creator><creator>Ivanovic, Jelena</creator><creator>Ferrajolo, Carmen</creator><creator>Molokhia, Mariam</creator><creator>Ballard, Clive</creator><creator>Sharp, Samantha</creator><creator>Sturkenboom, Miriam</creator><creator>Trifirò, Gianluca</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><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>3V.</scope><scope>4T-</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9622-169X</orcidid></search><sort><creationdate>20161101</creationdate><title>The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study</title><author>Sultana, Janet ; Fontana, Andrea ; Giorgianni, Francesco ; Pasqua, Alessandro ; Cricelli, Claudio ; Spina, Edoardo ; Gambassi, Giovanni ; Ivanovic, Jelena ; Ferrajolo, Carmen ; Molokhia, Mariam ; Ballard, Clive ; Sharp, Samantha ; Sturkenboom, Miriam ; Trifirò, Gianluca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-695c1c5330241542d2d3fd0957b2f0938a494e2dfe0620dd2c46074552e9e9ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Audits</topic><topic>Benzodiazepines - adverse effects</topic><topic>Benzodiazepines - therapeutic use</topic><topic>Data analysis</topic><topic>Databases, Factual</topic><topic>Dementia</topic><topic>Dementia - drug therapy</topic><topic>Drug Prescriptions</topic><topic>Female</topic><topic>Funding</topic><topic>Humans</topic><topic>Initiatives</topic><topic>Italy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Older people</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmacotherapy</topic><topic>Population</topic><topic>Practice Patterns, Physicians</topic><topic>Psychiatry</topic><topic>Psychopharmacology</topic><topic>Psychotropic drugs</topic><topic>Retrospective Studies</topic><topic>Risperidone - adverse effects</topic><topic>Risperidone - therapeutic use</topic><topic>Studies</topic><topic>Trends</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sultana, Janet</creatorcontrib><creatorcontrib>Fontana, Andrea</creatorcontrib><creatorcontrib>Giorgianni, Francesco</creatorcontrib><creatorcontrib>Pasqua, Alessandro</creatorcontrib><creatorcontrib>Cricelli, Claudio</creatorcontrib><creatorcontrib>Spina, Edoardo</creatorcontrib><creatorcontrib>Gambassi, Giovanni</creatorcontrib><creatorcontrib>Ivanovic, Jelena</creatorcontrib><creatorcontrib>Ferrajolo, Carmen</creatorcontrib><creatorcontrib>Molokhia, Mariam</creatorcontrib><creatorcontrib>Ballard, Clive</creatorcontrib><creatorcontrib>Sharp, Samantha</creatorcontrib><creatorcontrib>Sturkenboom, Miriam</creatorcontrib><creatorcontrib>Trifirò, Gianluca</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>CNS drugs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sultana, Janet</au><au>Fontana, Andrea</au><au>Giorgianni, Francesco</au><au>Pasqua, Alessandro</au><au>Cricelli, Claudio</au><au>Spina, Edoardo</au><au>Gambassi, Giovanni</au><au>Ivanovic, Jelena</au><au>Ferrajolo, Carmen</au><au>Molokhia, Mariam</au><au>Ballard, Clive</au><au>Sharp, Samantha</au><au>Sturkenboom, Miriam</au><au>Trifirò, Gianluca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study</atitle><jtitle>CNS drugs</jtitle><stitle>CNS Drugs</stitle><addtitle>CNS Drugs</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>30</volume><issue>11</issue><spage>1097</spage><epage>1109</epage><pages>1097-1109</pages><issn>1172-7047</issn><eissn>1179-1934</eissn><abstract>Background
Antipsychotic (AP) drugs are commonly used to manage the behavioural symptoms of dementia. Nevertheless, international (i.e. the European Medicines Agency in Europe) and national (i.e. the Medicines and Healthcare products Regulatory Agency in the UK and the Italian Drug Agency) regulatory agencies issued safety warnings against AP use in dementia in 2004 and 2009.
Objective
The aim of this study is to investigate the short- and long-term impact of safety warnings on the use of APs in UK and Italian persons with dementia using two nationwide databases: The Health Improvement Network (THIN) from the UK and the Health Search Database-Cegedim-Strategic Data-Longitudinal Patient Database (HSD-CSD-LPD) from Italy.
Methods
We calculated the overall quarterly prevalence of AP use by class and by individual drug in persons with dementia aged ≥65 years and used generalized linear models to explore the effect of the safety warnings.
Results
We identified 58,497 and 10,857 individuals aged ≥65 years with dementia from the THIN and HSD-CSD-LPD databases, respectively, over the period 2000–2012. After the 2004 warnings, the use of atypical APs decreased, whereas the use of conventional APs increased, in Italy and the UK until 2009. However, the trend for APs individually showed that the use of risperidone/olanzapine decreased, whereas the use of quetiapine increased in both countries. After the 2009 warnings (until 2012), the use of atypical and conventional APs decreased in the UK (from 11 to 9 and 5 to 3 %, respectively), but such use increased in Italy (from 11 to 18 and 9 to 14 %, respectively).
Conclusion
The 2004 warnings led to a reduction in the use of olanzapine and risperidone and increased the use of quetiapine/conventional APs in both countries. From 2009, the use of APs decreased in persons with dementia in the UK but not in Italy. Possible reasons for the difference in AP use between the two countries include a more proactive approach towards reducing the use of APs in the UK than in Italy.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27423216</pmid><doi>10.1007/s40263-016-0366-z</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-9622-169X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Audits Benzodiazepines - adverse effects Benzodiazepines - therapeutic use Data analysis Databases, Factual Dementia Dementia - drug therapy Drug Prescriptions Female Funding Humans Initiatives Italy Male Medicine Medicine & Public Health Mortality Neurology Neurosciences Older people Original Research Article Patients Pharmacotherapy Population Practice Patterns, Physicians Psychiatry Psychopharmacology Psychotropic drugs Retrospective Studies Risperidone - adverse effects Risperidone - therapeutic use Studies Trends United Kingdom |
| title | The Effect of Safety Warnings on Antipsychotic Drug Prescribing in Elderly Persons with Dementia in the United Kingdom and Italy: A Population-Based Study |
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