title: Antipsychotic drug treatment in ambulatory dementia care: prevalence and correlates.
abstract: BACKGROUND
  The present study is the first to analyze primary data about the use of antipsychotic drugs among community dwelling people with dementia in German primary care.
  
  
  OBJECTIVE
  To determine (1) prevalence of antipsychotic drug treatment in German primary care patients who screened positive for dementia and (2) factors associated with antipsychotic drug treatment.
  
  
  METHODS
  DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is an ongoing general practitioner-based, randomized, controlled intervention trial. A total of 4,064 community dwelling patients (≥70 years) recruited from 108 participating practices were screened for dementia (DemTect <9). Of 692 eligible patients (17%), a total of 406 patients provided informed consent (59%). Present analyses are based on data of 243 patients who completed baseline assessment before January 2014 (preliminary data).
  
  
  RESULTS
  Of the 243 patients who screened positive for dementia, a total of 25 patients (10%) received at least one antipsychotic drug. Atypical antipsychotic drugs (64%) were prescribed more often than typical antipsychotic drugs (36%). The results of the multivariate analysis showed that treatment by a specialist (neurologist/psychiatrist) was the only factor significantly associated with antipsychotic drug treatment (odds ratio, 12.86; p < 0.05; 95% confidence interval, 1.04-158.71).
  
  
  CONCLUSIONS
  Compared to the antipsychotic drug treatment rate among people with dementia living in nursing homes (>50%), the rate we found for community dwelling primary care patients who screened positive for dementia was low. Further research is needed to evaluate if these patients are adequately treated or if the antipsychotic drug treatment should and could be further reduced.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Tilly
authors.initials: T
authors.lastname: Eichler
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Wucherer
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Jochen René
authors.initials: JR
authors.lastname: Thyrian
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Kilimann
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hertel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalowsky
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Teipel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic
chemical_list: D014150:Antipsychotic Agents
keywords: Ambulatory care; antipsychotic drugs; dementia; general practitioner; primary health care