Assessment of the Risk of Antipsychotics in Patients with Dementia in Actual Clinical Practice in Primary Health Care.

María Del Carmen González-López,Tesifón Parrón-Carreño,Bruno José Nievas-Soriano,María José García-Ramón

doi:10.3390/ph14100997

María Del Carmen González-López, Tesifón Parrón-Carreño + Show 2 more

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https://doi.org/10.3390/ph14100997

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Abstract

Behavioral and psychological symptoms are almost universal in elderly patients with dementia. Antipsychotic drugs can be used but only in specific contexts as they can generate severe adverse effects. The main aim of this research was to evaluate the use of antipsychotic drugs in patients with accompanying treatment for dementia in actual clinical practice in primary health care. We further sought to analyze risk variables and factors associated and to acknowledge how sociodemographic and clinical factors weighed on adverse effects’ occurrence. A multicentric cross-sectional descriptive study was performed in three provinces of Spain. Stratified random sampling was performed to select 332 patients. Clinical data from their digital medical records were collected by their family doctors. The Global risk defined if the patients were subjected to risk. Univariate, bivariate, and multivariate analyses were performed. The most used antipsychotics were quetiapine (65.5%), haloperidol (21.75%), and risperidone (15.8%); 93.8% of patients showed risk, and 81.1% of doses and 75.5% of treatment durations were inappropriate. These two last factors increased the global risk 23 and 20 times, respectively. Conclusions: In actual clinical practice conditions, a high use of antipsychotic drugs was found in patients with dementia. Most patients had inappropriate doses and treatment duration, factors that increased the risk of adverse effects considerably.

Highlights

The analysis of the patients with concomitant treatment of anti-dementia and antipsychotic drugs showed that 75.2% of these treatments were initiated in primary health care
The main aim of this research was to evaluate the use of antipsychotic drugs in patients with accompanying treatment for dementia in actual clinical practice in primary health care
We further sought to analyze risk variables and factors that were associated with these patients and to acknowledge how sociodemographic and clinical factors weighed on adverse effects occurrence

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Dementia is one of the major causes of disability and dependence among older people. Ten million cases occur each year around the globe, age being the main risk for its development. Due to increasing lifespan and the ageing of the population in the developed and developing countries, dementia represents a fundamental challenge for public health systems. It is expected that the number of people with dementia will be 82 million in 2030, and 152 million in 2050 [1,2]

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