Antipsychotic Drug Use and Risk of Pneumonia in Elderly People
OBJECTIVES: To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people. DESIGN: A nested case‐control analysis. SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records. PARTICIPAN...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2008-04, Vol.56 (4), p.661-666 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
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| creator | Knol, Wilma Van Marum, Rob J. Jansen, Paul A. F. Souverein, Patrick C. Schobben, Alfred F. A. M. Egberts, Antoine C. G. |
| description | OBJECTIVES: To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people.
DESIGN: A nested case‐control analysis.
SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.
PARTICIPANTS: A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four randomly selected controls matched on index date.
MEASUREMENTS: Antipsychotic drug use in the year before the index date was classified as current, recent, or past use. No prescription for an antipsychotic in the year before the index date was classified as no use. The strength of the association between use of antipsychotics and the development of pneumonia was estimated using multivariate logistic regression analysis and expressed as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3–2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8–7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9–5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2–1.9). There was no clear dose‐response relationship.
CONCLUSION: Use of antipsychotics in elderly people is associated with greater risk of pneumonia. This risk is highest shortly after the initiation of treatment, with the greatest increase in risk found for atypical antipsychotics. |
| doi_str_mv | 10.1111/j.1532-5415.2007.01625.x |
| format | Article |
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DESIGN: A nested case‐control analysis.
SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.
PARTICIPANTS: A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four randomly selected controls matched on index date.
MEASUREMENTS: Antipsychotic drug use in the year before the index date was classified as current, recent, or past use. No prescription for an antipsychotic in the year before the index date was classified as no use. The strength of the association between use of antipsychotics and the development of pneumonia was estimated using multivariate logistic regression analysis and expressed as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3–2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8–7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9–5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2–1.9). There was no clear dose‐response relationship.
CONCLUSION: Use of antipsychotics in elderly people is associated with greater risk of pneumonia. This risk is highest shortly after the initiation of treatment, with the greatest increase in risk found for atypical antipsychotics.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/j.1532-5415.2007.01625.x</identifier><identifier>PMID: 18266664</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>adverse drug reactions ; Aged ; Aged, 80 and over ; Antipsychotic Agents - administration & dosage ; Antipsychotic Agents - adverse effects ; antipsychotics ; Biological and medical sciences ; Deglutition Disorders - chemically induced ; Deglutition Disorders - complications ; Dementia - drug therapy ; Dose-Response Relationship, Drug ; Drug Prescriptions ; elderly ; Epidemiology ; Female ; Follow-Up Studies ; General aspects ; Geriatrics ; Humans ; Male ; Medical sciences ; Miscellaneous ; Mobility Limitation ; nested case-control studies ; Netherlands - epidemiology ; Odds Ratio ; Older people ; Pneumonia ; Pneumonia - epidemiology ; Pneumonia - etiology ; Psychotropic drugs ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Retrospective Studies ; Risk factors</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2008-04, Vol.56 (4), p.661-666</ispartof><rights>2008, Copyright the Authors</rights><rights>2008 INIST-CNRS</rights><rights>Journal compilation © 2008, The American Geriatrics Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5595-5a10470737b3767cc033c6325485389c2b887cbc9addb2aaad74c97e164ccc113</citedby><cites>FETCH-LOGICAL-c5595-5a10470737b3767cc033c6325485389c2b887cbc9addb2aaad74c97e164ccc113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1532-5415.2007.01625.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1532-5415.2007.01625.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20567431$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18266664$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knol, Wilma</creatorcontrib><creatorcontrib>Van Marum, Rob J.</creatorcontrib><creatorcontrib>Jansen, Paul A. F.</creatorcontrib><creatorcontrib>Souverein, Patrick C.</creatorcontrib><creatorcontrib>Schobben, Alfred F. A. M.</creatorcontrib><creatorcontrib>Egberts, Antoine C. G.</creatorcontrib><title>Antipsychotic Drug Use and Risk of Pneumonia in Elderly People</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>OBJECTIVES: To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people.
DESIGN: A nested case‐control analysis.
SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.
PARTICIPANTS: A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four randomly selected controls matched on index date.
MEASUREMENTS: Antipsychotic drug use in the year before the index date was classified as current, recent, or past use. No prescription for an antipsychotic in the year before the index date was classified as no use. The strength of the association between use of antipsychotics and the development of pneumonia was estimated using multivariate logistic regression analysis and expressed as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3–2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8–7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9–5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2–1.9). There was no clear dose‐response relationship.
CONCLUSION: Use of antipsychotics in elderly people is associated with greater risk of pneumonia. This risk is highest shortly after the initiation of treatment, with the greatest increase in risk found for atypical antipsychotics.</description><subject>adverse drug reactions</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antipsychotic Agents - administration & dosage</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>antipsychotics</subject><subject>Biological and medical sciences</subject><subject>Deglutition Disorders - chemically induced</subject><subject>Deglutition Disorders - complications</subject><subject>Dementia - drug therapy</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Prescriptions</subject><subject>elderly</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General aspects</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Mobility Limitation</subject><subject>nested case-control studies</subject><subject>Netherlands - epidemiology</subject><subject>Odds Ratio</subject><subject>Older people</subject><subject>Pneumonia</subject><subject>Pneumonia - epidemiology</subject><subject>Pneumonia - etiology</subject><subject>Psychotropic drugs</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1vEzEQhi0EoqHwF5CFRG-7-NveA0hVUtJWVSkfhePI63XA6WY32FmR_Hu8JAoSJ-YyI_l5R-MHIUxJSXO9WZZUclZIQWXJCNEloYrJcvsITY4Pj9GEEMIKo6g4Qc9SWhJCGTHmKTqhhqlcYoLenXebsE4796PfBIdncfiO75PHtmvwp5AecL_Ad50fVn0XLA4dvmgbH9sdvvP9uvXP0ZOFbZN_cein6P79xZfpZXHzYX41Pb8pnJSVLKSlRGiiua65Vto5wrlTnElhJDeVY7Ux2tWusk1TM2tto4WrtKdKOOco5afobL93Hfufg08bWIXkfNvazvdDAkY0FbRSGXz1D7jsh9jl24BRwrXOXIbMHnKxTyn6BaxjWNm4A0pgFAxLGD3C6BFGwfBHMGxz9OVh_1CvfPM3eDCagdcHwCZn20W0nQvpyDEilRZ8_NHbPfcrtH733wfA9fzzOOV8sc-HtPHbY97GB1DZs4Rvt3P4-nF2fTudC5jx3-1sosY</recordid><startdate>200804</startdate><enddate>200804</enddate><creator>Knol, Wilma</creator><creator>Van Marum, Rob J.</creator><creator>Jansen, Paul A. F.</creator><creator>Souverein, Patrick C.</creator><creator>Schobben, Alfred F. A. M.</creator><creator>Egberts, Antoine C. G.</creator><general>Blackwell Publishing Inc</general><general>Blackwell</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>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7T2</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>200804</creationdate><title>Antipsychotic Drug Use and Risk of Pneumonia in Elderly People</title><author>Knol, Wilma ; Van Marum, Rob J. ; Jansen, Paul A. F. ; Souverein, Patrick C. ; Schobben, Alfred F. A. M. ; Egberts, Antoine C. G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5595-5a10470737b3767cc033c6325485389c2b887cbc9addb2aaad74c97e164ccc113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>adverse drug reactions</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antipsychotic Agents - administration & dosage</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>antipsychotics</topic><topic>Biological and medical sciences</topic><topic>Deglutition Disorders - chemically induced</topic><topic>Deglutition Disorders - complications</topic><topic>Dementia - drug therapy</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Prescriptions</topic><topic>elderly</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General aspects</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Mobility Limitation</topic><topic>nested case-control studies</topic><topic>Netherlands - epidemiology</topic><topic>Odds Ratio</topic><topic>Older people</topic><topic>Pneumonia</topic><topic>Pneumonia - epidemiology</topic><topic>Pneumonia - etiology</topic><topic>Psychotropic drugs</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knol, Wilma</creatorcontrib><creatorcontrib>Van Marum, Rob J.</creatorcontrib><creatorcontrib>Jansen, Paul A. F.</creatorcontrib><creatorcontrib>Souverein, Patrick C.</creatorcontrib><creatorcontrib>Schobben, Alfred F. A. M.</creatorcontrib><creatorcontrib>Egberts, Antoine C. G.</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>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knol, Wilma</au><au>Van Marum, Rob J.</au><au>Jansen, Paul A. F.</au><au>Souverein, Patrick C.</au><au>Schobben, Alfred F. A. M.</au><au>Egberts, Antoine C. G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antipsychotic Drug Use and Risk of Pneumonia in Elderly People</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2008-04</date><risdate>2008</risdate><volume>56</volume><issue>4</issue><spage>661</spage><epage>666</epage><pages>661-666</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>OBJECTIVES: To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people.
DESIGN: A nested case‐control analysis.
SETTING: Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.
PARTICIPANTS: A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four randomly selected controls matched on index date.
MEASUREMENTS: Antipsychotic drug use in the year before the index date was classified as current, recent, or past use. No prescription for an antipsychotic in the year before the index date was classified as no use. The strength of the association between use of antipsychotics and the development of pneumonia was estimated using multivariate logistic regression analysis and expressed as odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Current use of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3–2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8–7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9–5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2–1.9). There was no clear dose‐response relationship.
CONCLUSION: Use of antipsychotics in elderly people is associated with greater risk of pneumonia. This risk is highest shortly after the initiation of treatment, with the greatest increase in risk found for atypical antipsychotics.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>18266664</pmid><doi>10.1111/j.1532-5415.2007.01625.x</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of the American Geriatrics Society (JAGS), 2008-04, Vol.56 (4), p.661-666 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | adverse drug reactions Aged Aged, 80 and over Antipsychotic Agents - administration & dosage Antipsychotic Agents - adverse effects antipsychotics Biological and medical sciences Deglutition Disorders - chemically induced Deglutition Disorders - complications Dementia - drug therapy Dose-Response Relationship, Drug Drug Prescriptions elderly Epidemiology Female Follow-Up Studies General aspects Geriatrics Humans Male Medical sciences Miscellaneous Mobility Limitation nested case-control studies Netherlands - epidemiology Odds Ratio Older people Pneumonia Pneumonia - epidemiology Pneumonia - etiology Psychotropic drugs Public health. Hygiene Public health. Hygiene-occupational medicine Retrospective Studies Risk factors |
| title | Antipsychotic Drug Use and Risk of Pneumonia in Elderly People |
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