Department of Economics and Business Economics

Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia: A Nationwide Study

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  • Johanne Købstrup Zakarias, Department of Neurology, Danish Dementia Research Centre (DDRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Christina Jensen-Dahm, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Ane Nørgaard, Department of Neurology, Danish Dementia Research Centre (DDRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Lea Stevnsborg, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • ,
  • Christiane Gasse
  • Bodil Gramkow Andersen, Aalborg Psychiatric University Hospital, Aalborg, Denmark Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Jakobsen Søren, Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark.
  • ,
  • Frans Boch Waldorff, Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
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  • Torben Moos, Laboratory of Neurobiology, Biomedicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  • ,
  • Gunhild Waldemar, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

BACKGROUND: Use of antipsychotics in elderly patients with dementia has decreased in the past decade due to safety regulations; however use is still high. Geographical variation may indicate discrepancies in clinical practice and lack of adherence to evidence-based guidelines for the management of behavioral symptoms.

OBJECTIVE: To investigate potential geographical variances in use of antipsychotic drugs in dementia care.

METHODS: A registry-based cross-sectional study in the entire elderly population of Denmark (≥65 years) conducted in 2012. Data included place of residence, prescriptions filled, and hospital discharge diagnoses. Antipsychotic drug use among elderly with (n = 34,536) and without (n = 931,203) a dementia diagnosis was compared across the five regions and 98 municipalities in Denmark, adjusted for age and sex.

RESULTS: In 2012, the national prevalence of antipsychotic drug use was 20.7% for elderly patients with dementia, with a national incidence of 3.9%. The prevalence ranged from 17.0% to 23.3% in the five regions and from 7.5% to 33.1% in the 98 municipalities, demonstrating an over four-fold difference.

CONCLUSION: The observed geographical variation was more pronounced at municipal level as compared to regional level, suggesting that the variation may be related to variances in clinical practice in primary care. This study highlights an urgent need for further educating professional carers and physicians to guide non-pharmacological as well as pharmacological management of neuropsychiatric symptoms in elderly patients with dementia.

Original languageEnglish
JournalJournal of Alzheimer's Disease
Volume54
Issue3
Pages (from-to)1183-1192
Number of pages10
ISSN1387-2877
DOIs
Publication statusPublished - 2016

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