PMID- 37366328
OWN - NLM
STAT- MEDLINE
DCOM- 20230628
LR  - 20230809
IS  - 1468-2834 (Electronic)
IS  - 0002-0729 (Print)
IS  - 0002-0729 (Linking)
VI  - 52
IP  - 6
DP  - 2023 Jun 1
TI  - Trends in the use of psychotropics in older people with dementia: interrupted 
      time series of Finnish clinical guidelines of behavioural and psychological 
      symptoms of dementia.
LID - 10.1093/ageing/afad094 [doi]
LID - afad094
AB  - BACKGROUND: Up to 90% of people with dementia experience behavioural and 
      psychological symptoms of dementia (BPSD) as part of their illness. Psychotropics 
      are not recommended as the first-line treatment of BPSD because older people are 
      more prone to adverse reactions. In this study, we evaluate the impact of the 
      Finnish clinical guidelines of BPSD (published in 2017) on psychotropic use in 
      people with dementia. METHODS: This study is based on Finnish Prescription 
      Register data from 2009 to 2020. The data included all community-dwelling Finnish 
      people aged >/=65 and who had anti-dementia medication purchases (n = 217,778). We 
      used three-phased interrupted time series design to evaluate the changes in 
      levels and trends of monthly (n = 144) psychotropic user rates compared with the 
      predicted trends. In addition, we evaluated the changes in levels and trends of 
      monthly new psychotropic user rates. RESULTS: The level of monthly psychotropic 
      user rate decreased non-significantly during the intervention period (beta -0.057, 
      P = 0.853), and during the post-intervention period, there was an increase in the 
      level (beta 0.443, P = 0.091) and slope (beta 0.199, P = 0.198), but not statistically 
      significant. The level of monthly new psychotropic user rate (beta -0.009, 
      P = 0.949) during the intervention period and the level (beta 0.044, P = 0.714) and 
      slope (beta 0.021, P = 0.705) during the post-intervention period were almost 
      unchanged. CONCLUSIONS: Results may indicate possible challenges in deprescribing 
      and better adherence to the guidelines at the beginning of BPSD treatment. 
      Further research into the barriers to implement BPSD guidelines and the 
      availability of non-pharmacological treatments is needed.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      British Geriatrics Society.
FAU - Rantsi, Mervi
AU  - Rantsi M
AUID- ORCID: 0000-0002-0974-4474
AD  - Department of Health and Social Management, University of Eastern Finland, 
      Kuopio, Finland.
FAU - Kortelainen, Lauri
AU  - Kortelainen L
AD  - Department of Health and Social Management, University of Eastern Finland, 
      Kuopio, Finland.
FAU - Hyttinen, Virva
AU  - Hyttinen V
AD  - Department of Health and Social Management, University of Eastern Finland, 
      Kuopio, Finland.
FAU - Jyrkka, Johanna
AU  - Jyrkka J
AD  - Information and Development Services Unit, Finnish Medicines Agency, Helsinki, 
      Finland.
FAU - Kankaanpaa, Eila
AU  - Kankaanpaa E
AD  - Department of Health and Social Management, University of Eastern Finland, 
      Kuopio, Finland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Age Ageing
JT  - Age and ageing
JID - 0375655
RN  - 0 (Psychotropic Drugs)
SB  - IM
MH  - Humans
MH  - Aged
MH  - Finland/epidemiology
MH  - Interrupted Time Series Analysis
MH  - *Psychotropic Drugs/adverse effects
MH  - *Mental Disorders/drug therapy
PMC - PMC10294559
OTO - NOTNLM
OT  - behavioural and psychological symptoms of dementia
OT  - clinical guidelines
OT  - impact
OT  - interrupted time series
OT  - older people
OT  - psychotropics
COIS- None.
EDAT- 2023/06/27 13:10
MHDA- 2023/06/28 06:43
PMCR- 2023/06/26
CRDT- 2023/06/27 07:42
PHST- 2022/11/04 00:00 [received]
PHST- 2023/03/15 00:00 [revised]
PHST- 2023/06/28 06:43 [medline]
PHST- 2023/06/27 13:10 [pubmed]
PHST- 2023/06/27 07:42 [entrez]
PHST- 2023/06/26 00:00 [pmc-release]
AID - 7207834 [pii]
AID - afad094 [pii]
AID - 10.1093/ageing/afad094 [doi]
PST - ppublish
SO  - Age Ageing. 2023 Jun 1;52(6):afad094. doi: 10.1093/ageing/afad094.