title: Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia: A Nationwide Study.
abstract: 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.
  
  
  
  To investigate potential geographical variances in use of antipsychotic drugs in dementia care.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors: Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.|Laboratory of Neurobiology, Biomedicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors: Johanne Købstrup
authors: JK
authors: Zakarias
authors: Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Christina
authors: C
authors: Jensen-Dahm
authors: Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Ane
authors: A
authors: Nørgaard
authors: Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Lea
authors: L
authors: Stevnsborg
authors: National Centre for Register Based Research, Aarhus University, Aarhus, Denmark.
authors: Christiane
authors: C
authors: Gasse
authors: Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
authors: Bodil Gramkow
authors: BG
authors: Andersen
authors: Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark.
authors: Jakobsen
authors: J
authors: Søren
authors: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Frans Boch
authors: FB
authors: Waldorff
authors: Laboratory of Neurobiology, Biomedicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors: Torben
authors: T
authors: Moos
authors: Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Gunhild
authors: G
authors: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D012042:Registries
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic drugs; clinical practice variation; dementia; geography; small area variation