PMID- 21456106
OWN - NLM
STAT- MEDLINE
DCOM- 20110621
LR  - 20191027
IS  - 1473-5857 (Electronic)
IS  - 0268-1315 (Linking)
VI  - 24
IP  - 2
DP  - 2009 Mar
TI  - Use and misuse of antipsychotic drugs in patients with dementia in Alzheimer 
      special care units.
PG  - 97-104
AB  - The objective of this study was to estimate the prevalence of antipsychotic use 
      and investigate their association with behavioural and psychological symptoms of 
      dementia (BPSD) and other clinical predictors. Patients with dementia, aged 65 
      and above and resident in 35 Alzheimer special care units were sequentially 
      enrolled into a 18-month prospective observational study. Data on 
      sociodemographic, cognitive, functional, behavioural and clinical characteristics 
      and drug exposure were collected at baseline and at 6-month intervals up to 18 
      months. The prevalence of antipsychotic use and the association with BPSD and 
      clinical predictors were analysed. Of the 349 patients with dementia enrolled in 
      the study, 209 (60%) were taking at least one antipsychotic. Risperidone and 
      promazine were the most frequently prescribed antipsychotic; 40.7% simultaneously 
      received a benzodiazepine, 20% an antidepressant. More than 50% were still taking 
      antipsychotics at 18 months of follow-up. No associations were found between 
      antipsychotic use and level of cognitive impairment, basal activity of daily 
      living disability and comorbidity. Multivariate analysis showed that the use of 
      antipsychotics was highest in patients in the highest quartiles of 
      Neuropsychiatric Inventory Scale score (III quartile, odds ratio: 1.63; 95% 
      confidence interval: 1.19-2.23; IV quartile, odds ratio: 2.27; 95% confidence 
      interval: 1.61-3.26). This study found high rate of use of antipsychotics in 
      patients with dementia resident in Alzheimer special care units, frequent 
      associations with other psychotropic medications and a strong correlation with 
      BPSD.
FAU - Nobili, Alessandro
AU  - Nobili A
AD  - Laboratory of Quality Assessment of Geriatric Therapies and Services, Istituto di 
      Ricerche Farmacologiche 'Mario Negri', Via Giuseppe La Masa 19, Milan 20156, 
      Italy. nobili@marionegri.it
FAU - Pasina, Luca
AU  - Pasina L
FAU - Trevisan, Silvia
AU  - Trevisan S
FAU - Riva, Emma
AU  - Riva E
FAU - Lucca, Ugo
AU  - Lucca U
FAU - Tettamanti, Mauro
AU  - Tettamanti M
FAU - Matucci, Marina
AU  - Matucci M
FAU - Tarantola, Massimo
AU  - Tarantola M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Int Clin Psychopharmacol
JT  - International clinical psychopharmacology
JID - 8609061
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antipsychotic Agents)
RN  - 12794-10-4 (Benzodiazepines)
RN  - L6UH7ZF8HC (Risperidone)
RN  - O9M39HTM5W (Promazine)
SB  - IM
MH  - Activities of Daily Living
MH  - Aged
MH  - Aged, 80 and over
MH  - Alzheimer Disease/*physiopathology
MH  - Antidepressive Agents/therapeutic use
MH  - Antipsychotic Agents/*therapeutic use
MH  - Benzodiazepines/therapeutic use
MH  - Cognition/drug effects
MH  - Comorbidity
MH  - Dementia/*drug therapy/etiology
MH  - *Drug Utilization
MH  - Female
MH  - Humans
MH  - Male
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Promazine/therapeutic use
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales
MH  - *Residential Facilities
MH  - Risperidone/therapeutic use
EDAT- 2009/03/01 00:00
MHDA- 2011/06/22 06:00
CRDT- 2011/04/02 06:00
PHST- 2011/04/02 06:00 [entrez]
PHST- 2009/03/01 00:00 [pubmed]
PHST- 2011/06/22 06:00 [medline]
AID - 10.1097/yic.0b013e328323aaf0 [doi]
PST - ppublish
SO  - Int Clin Psychopharmacol. 2009 Mar;24(2):97-104. doi: 
      10.1097/yic.0b013e328323aaf0.