title: Treatment patterns and characteristics of older antipsychotic users in Germany.
abstract: The aim of this study was to investigate the characteristics and treatment patterns of older antipsychotic (AP) users in Germany. We carried out a cohort study in the German Pharmacoepidemiological Research Database and identified new AP users aged at least 65 years between 2005 and 2011. Possible indications, comedication, and information on persistence and adherence, concurrent multiple use, and switch of APs were assessed. Overall, 298,847 individuals were included in the cohort. Almost 70% entered the cohort with a typical antipsychotic (TAP). Melperone (23.4%) was used most frequently, followed by promethazine (18.3%), sulpiride (11.0%), and risperidone (10.3%). AP users had a low prevalence of schizophrenia and bipolar disorders in contrast to dementia. Initiators of atypical antipsychotics had more treatment episodes compared with TAPs (median 3 vs. 2), but lower median persistence (14 vs. 22 days). Persistence was also lower in patients with, rather than without, dementia. The overall percentage of concurrent multiple use and switch to other APs was low with 5.6%, but higher in patients with, rather than without, dementia. In conclusion, APs were used for a broad range of indications, mostly other than schizophrenia and bipolar disorders. Low persistence and a high number of treatment episodes suggest frequent 'as-needed' treatment, especially in dementia patients.
authors.affiliation: aLeibniz Institute for Prevention Research and Epidemiology, BIPS GmbH bFaculty of Human and Health Sciences, University of Bremen, Bremen cDepartment of Psychiatry and Psychotherapy, Georg-August University of Goettingen, Goettingen dFederal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Schmedt
authors.forename: Kathrin
authors.initials: K
authors.lastname: Jobski
authors.forename: Bianca
authors.initials: B
authors.lastname: Kollhorst
authors.forename: Jutta
authors.initials: J
authors.lastname: Krappweis
authors.forename: Eckart
authors.initials: E
authors.lastname: Rüther
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.forename: Edeltraut
authors.initials: E
authors.lastname: Garbe
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents