title: Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer's disease in 2005-2011.
abstract: OBJECTIVE
  To describe and compare temporal changes in prevalence and incidence of psychotropic use (antipsychotics, antidepressants and benzodiazepines and related drugs; BZDRs) in persons with newly diagnosed Alzheimer's disease (AD) between university hospital districts of Finland during 2005-2011.
  
  
  METHODS
  The MEDALZ study includes all community-dwellers of Finland who received a clinically verified AD diagnosis in 2005-2011 (N = 70,718). Prevalent and incident use of psychotropics among those who had received AD diagnosis less than one year ago were compared in 2005-2011.
  
  
  RESULTS
  Regional differences in psychotropic use between university hospital districts were more evident in 2005 than 2011 for prevalent use of any psychotropic, antipsychotic and BZDRs and incident use of any psychotropic and antipsychotics. Regional differences in prevalent antidepressant use and incident BZDR use remained similar during the follow-up, while differences in incident antidepressant use increased during the follow-up. The prevalence of any psychotropic use in 2005 varied between 44.7-50.7% and between 45.0-47.9% in 2011. Incidence of any psychotropic use in 2005 was between 8.6-12.1% and 6.2-8.2% in 2011. In 2005, the distribution of incident psychotropic use followed a large scale spatial variation that, however, did not correspond to university hospital districts. During the study period from 2005 to 2011 the cyclic spatial variation disappeared. No sign of adjacent hospital districts being more or less closely related to each other compared to hospital districts in general was detected.
  
  
  CONCLUSIONS
  Except for antidepressants, regional differences in psychotropic use have mainly diminished between 2005 and 2011. Our findings highlight the importance of acknowledging regional differences in a country with relatively homogeneous healthcare system and conducting future studies assessing the reasons behind these differences.
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.identifier: http://orcid.org/0000-0001-9270-9268
authors.initials: AM
authors.lastname: Tolppanen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Voutilainen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.|Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Heidi
authors.initials: H
authors.lastname: Taipale
authors.affiliation: Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Tanskanen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Piia
authors.initials: P
authors.lastname: Lavikainen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: Marjaana
authors.initials: M
authors.lastname: Koponen
authors.affiliation: Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs