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

Research output: Contribution to journalJournal articleResearchpeer-review

Johanne Købstrup Zakarias, Christina Jensen-Dahm, Ane Nørgaard, Lea Stevnsborg, Christiane Gasse, Bodil Gramkow Andersen, Søren Jacobsen, Frans Boch Waldorff, Torben Moos, Gunhild Waldemar

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
Issue number3
Pages (from-to)1183-1192
Number of pages10
ISSN1387-2877
DOIs
Publication statusPublished - 4 Oct 2016

ID: 171796420