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Anti-dementia drugs and co-medication among patients with Alzheimer's disease : investigating real-world drug use in clinical practice using the Swedish Dementia Quality Registry (SveDem).

https://arctichealth.org/en/permalink/ahliterature259016
Source
Drugs Aging. 2014 Mar;31(3):215-24
Publication Type
Article
Date
Mar-2014
Author
Seyed-Mohammad Fereshtehnejad
Kristina Johnell
Maria Eriksdotter
Source
Drugs Aging. 2014 Mar;31(3):215-24
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy
Cholinesterase Inhibitors - administration & dosage - therapeutic use
Drug Therapy, Combination
Female
Humans
Male
Polypharmacy
Psychotropic Drugs - administration & dosage - therapeutic use
Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors
Registries
Sweden
Abstract
There is a substantial risk of drug-interactions, adverse events, and inappropriate drug use (IDU) among frail Alzheimer's disease (AD) patients; however, there are few studies about co-medication and IDU in clinical settings.
To investigate anti-dementia drugs, associated characteristics of cholinesterase inhibitors (ChEIs) and NMDA antagonists, co-medication, and IDU in a large population of outpatients with mild AD.
In this cross-sectional analysis of medication characteristics, we analyzed data from the Swedish Dementia Quality Registry (SveDem) on 5,907 newly diagnosed AD patients who were registered in memory clinics. SveDem is a national quality registry in Sweden, which was established in 2007 to evaluate and improve dementia healthcare. Comparisons were performed concerning co-medications, use of =3 psychotropic drugs (IDU) and polypharmacy (=5 drugs) based on anti-dementia treatment (ChEIs or NMDA antagonists). Information on baseline characteristics such as age, sex, living conditions, cognitive evaluation based on the Mini-Mental State Examination (MMSE) score, and diagnostic work-up was also evaluated.
The majority of the AD patients were in the mild stage of the disease. Overall, 4,342 (75.4 %) patients received any ChEI, 438 (7.6 %) used an NMDA antagonist and 74 (1.3 %) patients were treated with both. However, 907 (15.7 %) patients were not treated with any anti-dementia drug. While polypharmacy was seen in 33.5 % of patients, only 2.6 % concurrently used =3 psychotropic medications. Patients on ChEIs were significantly younger, had a higher MMSE score and were treated with a smaller number of medications (a proxy for overall co-morbidity). Co-medication with antipsychotics [3.3 vs. 7.6 %; adjusted odds ratio (OR) 0.55 (95 % CI 0.38-0.79)] and anxiolytics [5.8 vs. 10.9 %; adjusted OR 0.62 (95 % CI 0.46-0.84)] was significantly lower in the ChEI+ group than in those with no anti-dementia treatment.
Patients taking ChEIs were treated with less antipsychotics and anxiolytics than those not taking ChEIs. More research is warranted to elucidate whether use of ChEIs in clinical practice can reduce the need for psychotropic drugs in AD patients.
PubMed ID
24497071 View in PubMed
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The barriers to patient-driven treatment in mental health: why patients may choose to follow their own path.

https://arctichealth.org/en/permalink/ahliterature170158
Source
Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006;19(1):xi-xxv
Publication Type
Article
Date
2006
Author
Paul Greenall
Author Affiliation
Ministry of Health and Long Time Care, Penetanguishene, Canada.
Source
Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006;19(1):xi-xxv
Date
2006
Language
English
Publication Type
Article
Keywords
Behavioral Research
Cost of Illness
Halfway Houses
Health Services Research
Helplessness, Learned
Hospitals, Psychiatric - economics - organization & administration - utilization
Humans
Informed consent
Interviews as Topic
Mental Disorders - drug therapy - economics
Mental Health Services - economics - organization & administration - utilization
Ontario
Paternalism
Patient Compliance - psychology
Patient Participation
Patient Readmission
Patient-Centered Care
Physician-Patient Relations
Psychotropic Drugs - administration & dosage - therapeutic use
Abstract
The paper aims to explore the barriers that currently exist to patient-driven treatment within the field of mental health care and reform.
This study represents action learning research using grounded theory to explore a possible causal basis for recidivism related to non-compliance with medication. Interviews addressed concerns from the literature around perceived barriers to patient-driven treatment evidenced by non-compliance with medically recommended pharmaceutical treatment. Results were correlated to look for emergent themes that were used to form the basis for subsequent interview questions.
An analysis of the resulting emergent themes illustrated the importance of participatory treatment and coaching rather than medically applied paternalistic care, which is seen as encouraging learned helplessness on the part of patients. Similar helplessness was also revealed in clinicians themselves. Patients' awareness of their own needs and demands for more services place clients and the caregivers at odds over appropriate care in an environment of limited resources.
The research was limited to only a small number of interviewees in one institution, all of whom were closely associated with mental illness in various capacities. The grounded theory nature of the research does, however, provide a framework for more research in other institutions to test and further explore some of the findings.
The study demonstrated a reinforcement of Maslow's theory of needs hierarchy. The study illustrated a step-wise approach to treatment to decrease the rate of failure and recidivism in mental health care. The provision of a stable living environment was viewed as instrumental in improving patients' compliance with pharmaceutical treatment. An action plan was therefore created to initiate the support of a transitional/emergency house by various community groups in partnership with pharmaceutical manufacturing companies.
Recidivism in mental health-created by non-compliance in pharmaceutical treatment, is a major issue in Canada's health care system. This study brings to the forefront issues from a number of perspectives in order to form a course of action in response to its findings.
PubMed ID
16548400 View in PubMed
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Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011.

https://arctichealth.org/en/permalink/ahliterature297761
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2018
Author
G Selbæk
S I M Janus
S Bergh
K Engedal
S Ruths
A S Helvik
J Šaltyte Benth
S U Zuidema
Author Affiliation
Norwegian National Advisory Unit on Ageing and Health,Vestfold Hospital Trust,Tønsberg,Norway.
Source
Int Psychogeriatr. 2018 03; 30(3):385-394
Date
03-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Antipsychotic Agents - therapeutic use
Behavioral Symptoms - drug therapy - psychology
Cognition Disorders - drug therapy - psychology
Cohort Studies
Dementia - drug therapy - psychology
Drug Utilization - statistics & numerical data
Female
Homes for the Aged
Humans
Length of Stay - statistics & numerical data
Male
Norway - epidemiology
Nursing Homes - statistics & numerical data
Psychotic Disorders - drug therapy - epidemiology
Psychotropic Drugs - administration & dosage - therapeutic use
Abstract
ABSTRACTBackground:We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed.
We conducted a secondary analysis of two cohort studies of two Norwegian nursing home samples (2004/05 and 2010/11). Multivariate models were applied.
We found a significant decrease in the prescription of antipsychotic drugs between 2004 and 2011 (0.63 OR, 95%CI = 0.49-0.82, p
PubMed ID
28988552 View in PubMed
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Childhood adversities predict strongly the use of psychotropic drugs in adulthood: a population-based cohort study of 24,284 Finns.

https://arctichealth.org/en/permalink/ahliterature268779
Source
J Epidemiol Community Health. 2015 Apr;69(4):354-60
Publication Type
Article
Date
Apr-2015
Author
Karoliina Koskenvuo
Markku Koskenvuo
Source
J Epidemiol Community Health. 2015 Apr;69(4):354-60
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adult
Adult Survivors of Child Adverse Events - psychology - statistics & numerical data
Alcohol Drinking - epidemiology - psychology
Child
Cohort Studies
Divorce - psychology
Family Health
Family Relations - psychology
Fear - psychology
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Humans
Logistic Models
Male
Mental Disorders - drug therapy - epidemiology - etiology
Middle Aged
Poverty - psychology
Psychotropic Drugs - administration & dosage - therapeutic use
Risk factors
Smoking - epidemiology - psychology
Young Adult
Abstract
Exposure to adverse childhood experiences has been shown to be associated with negative health outcomes including mental health problems, but only a few studies with register-based data have used psychotropic drugs as an outcome variable. The purpose of this study is to examine whether adverse emotional childhood experiences, such as serious conflicts in the family and frequent fear of a family member, predict the use of psychotropic drugs in adulthood. In addition, the association of a child-parent relationship during childhood with the use of psychotropic drugs is studied.
The participants of the population-based Health and Social Support Study (24,284 working aged Finns) were followed up for 9 years. The information on childhood experiences and child-parent relationships was obtained from the questionnaires in 1998 and 2003. The number of psychotropic purchases (antipsychotics, drugs for bipolar disorder, antidepressants, anxiolytics, hypnotics and sedatives) was obtained from the National-Drug-Prescription-Register. Logistic and multinomial regression models were used.
A graded association between childhood adversities and the use of psychotropic drugs was found, even after adjustments for occupational training, work status, recent life events and health behaviour. Frequent fear of a family member showed the strongest association: the OR for multiple use of antidepressants was 3.08 (95% CI 2.72 to 3.49) and 2.69 (2.27 to 3.20) for multiple use of anxiolytics. Use of psychotropic drugs was clearly increased among those with poor child-parent relationship and multiple childhood adversities.
The results highlight the effect of environmental factors during childhood on mental health and the need for early recognition of families at risk.
PubMed ID
25538256 View in PubMed
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[Comparative study of alpha-lipoic acid and mexidol effects on affective status, cognitive functions and quality of life in diabetes mellitus patients].

https://arctichealth.org/en/permalink/ahliterature127505
Source
Eksp Klin Farmakol. 2011;74(11):17-23
Publication Type
Article
Date
2011
Author
I A Volchegorskii
L M Rassokhina
M I Koliadich
M I Alekseev
Source
Eksp Klin Farmakol. 2011;74(11):17-23
Date
2011
Language
Russian
Publication Type
Article
Keywords
Antioxidants - administration & dosage - therapeutic use
Attention - drug effects
Cognition - drug effects
Cognition Disorders - drug therapy - metabolism - physiopathology
Diabetes Complications - drug therapy
Diabetes Mellitus - drug therapy - metabolism - physiopathology
Double-Blind Method
Female
Humans
Hyperglycemia - drug therapy
Hyperlipidemias - drug therapy - metabolism
Hypoglycemic Agents - administration & dosage - therapeutic use
Lipid Peroxidation - drug effects
Male
Middle Aged
Picolines - administration & dosage - therapeutic use
Placebos
Prospective Studies
Psychotropic Drugs - administration & dosage - therapeutic use
Quality of Life
Questionnaires
Russia
Thioctic Acid - administration & dosage - therapeutic use
Abstract
Short-term, prospective placebo-controlled simple blind randomized study of the effects of alpha-lipoic acid and mexidol on the dynamics of affective status disorders, cognitive functions, and quality of life in parallel with changes in carbohydrate metabolism and lipidemia has been conducted in diabetic patients. It is established that two-week administration of alpha-lipoic acid (600 mg once a day, i.v.) and mexidol (300 mg once a day, i.v.) reduced hyperglycemia by 13.00 with simultaneous decrease of depressive "feelings of guilt". In case of mexidol, these effects were accompanied by positive "vitality" dynamics established with SF-36 questionnaire and reflecting improvement in patients' quality of life. Additionally, course administration of alpha-lipoic acid increased attention as studied with Schulte tables. Favorable psychotropic effects of alpha-lipoic acid and mexidol were unrelated to changes in lipidemia and "lipid peroxidation - antioxidant protection" system indicators.
PubMed ID
22288155 View in PubMed
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A Comparison of Sex Differences in Psychotropic Medication Use in Older People with Alzheimer's Disease in the US and Finland.

https://arctichealth.org/en/permalink/ahliterature285249
Source
Drugs Aging. 2017 Jan;34(1):55-65
Publication Type
Article
Date
Jan-2017
Author
Daniela C Moga
Heidi Taipale
Anna-Maija Tolppanen
Antti Tanskanen
Jari Tiihonen
Sirpa Hartikainen
Qishan Wu
Gregory A Jicha
Danijela Gnjidic
Source
Drugs Aging. 2017 Jan;34(1):55-65
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy - psychology
Anti-Anxiety Agents - administration & dosage - therapeutic use
Antidepressive Agents - administration & dosage - therapeutic use
Antipsychotic Agents - administration & dosage - therapeutic use
Drug Utilization - statistics & numerical data
Female
Finland - epidemiology
Humans
Hypnotics and Sedatives - administration & dosage - therapeutic use
Logistic Models
Male
Middle Aged
Odds Ratio
Prevalence
Psychotropic Drugs - administration & dosage - therapeutic use
Sex Characteristics
United States - epidemiology
Abstract
Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland.
We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex.
We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p 
Notes
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PubMed ID
27896799 View in PubMed
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Milieu and mental health in a Norwegian fishing community.

https://arctichealth.org/en/permalink/ahliterature6254
Source
Psychother Psychosom. 1979;32(1-4):60-4
Publication Type
Article
Date
1979
Author
P. Fugelli
Source
Psychother Psychosom. 1979;32(1-4):60-4
Date
1979
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Arctic Regions
Child
Environment
Female
Fisheries
Health Surveys
Humans
Male
Mental Disorders - drug therapy - epidemiology
Mental health
Middle Aged
Norway
Psychotropic Drugs - administration & dosage - therapeutic use
Rural Population
Seasons
Socioeconomic Factors
Abstract
During 1970-1973 a comprehensive epidemiological investigation was carried out on the island of Vaerøy and Røst in Northern Norway; 1,700 people live in the area and fishing provides the main employment. The paper contains mainly a morbidity study, with special reference to factors in the local milieu influencing the morbidity pattern. A few of the major results concerning living conditions and mental health in this fishing population are presented.
PubMed ID
550189 View in PubMed
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Pattern of psychotropic drug use among older adults having a depression or an anxiety disorder: results from the longitudinal ESA study.

https://arctichealth.org/en/permalink/ahliterature132962
Source
Can J Psychiatry. 2011 Jun;56(6):348-57
Publication Type
Article
Date
Jun-2011
Author
Michel Préville
Helen-Maria Vasiliadis
Cindy Bossé
Pierre-Alexandre Dionne
Philippe Voyer
Joëlle Brassard
Author Affiliation
Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Quebec; Researcher, Research Centre, Charles LeMoyne Hospital, Greenfield Park, Quebec. michel.preville@usherbrooke.c
Source
Can J Psychiatry. 2011 Jun;56(6):348-57
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Aged
Antidepressive Agents - administration & dosage - therapeutic use
Anxiety Disorders - diagnosis - drug therapy - epidemiology
Benzodiazepines - administration & dosage - therapeutic use
Cross-Sectional Studies
Depressive Disorder - diagnosis - drug therapy - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Drug Administration Schedule
Female
Health Surveys
Humans
Longitudinal Studies
Male
Prevalence
Psychotropic Drugs - administration & dosage - therapeutic use
Quebec - epidemiology
Self Report
Sex Factors
Abstract
To document the use of psychotropic drugs in Quebec older adult population with a depressive or anxiety disorder.
Data from the Enquête sur la Santé des Aînés (ESA) study conducted between 2005 and 2008 using a representative sample (n = 1869) of community-dwelling adults aged 65 years and older were used to examine the use of psychotropic drugs in the Quebec older adult population.
Our results indicate that only 46.9% of the older adults with a diagnosis of depression or anxiety during the 24-month period studied according to the Régie de l'assurance maladie du Quebec (RAMQ) register used antidepressants (AD) for 400 days (12.9 months) on average during this period. Also, 59% of the RAMQ's mental health disorder patients used a mean daily dose of 5 mg of a diazepam equivalent for 338 days (10.9 months) on average during the same period. However, 10.0% of the older adults without any symptoms (ESA) at T1 and at T2 and any RAMQ depression and anxiety diagnosis between T0 and T2 were AD users during the 24-month period studied. They represent 26.2% of the AD users and consumed them for 494 days (15.9 months) on average during the 24-month period studied. Finally, the number of days of AD and benzodiazepine use was not associated with partial or total remission.
This result questions the population effectiveness of these drugs in this population.
PubMed ID
21756449 View in PubMed
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[Prescription of psychopharmaceuticals for children illustrated by review of prescriptions]

https://arctichealth.org/en/permalink/ahliterature42126
Source
Ugeskr Laeger. 1976 Dec 13;138(51):3287-91
Publication Type
Article
Date
Dec-13-1976

18 records – page 1 of 2.