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Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic.
Luo, Hao; Lau, Wallis C Y; Chai, Yi; Torre, Carmen Olga; Howard, Robert; Liu, Kathy Y; Lin, Xiaoyu; Yin, Can; Fortin, Stephen; Kern, David M; Lee, Dong Yun; Park, Rae Woong; Jang, Jae-Won; Chui, Celine S L; Li, Jing; Reich, Christian; Man, Kenneth K C; Wong, Ian C K.
  • Luo H; Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong.
  • Lau WCY; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong.
  • Chai Y; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
  • Torre CO; Research Department of Practice and Policy, UCL School of Pharmacy, London, England.
  • Howard R; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
  • Liu KY; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong.
  • Lin X; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
  • Yin C; Real World Data Enabling Platform, Roche, Welwyn Garden City, England.
  • Fortin S; School of Science and Engineering, University of Groningen, Groningen, the Netherlands.
  • Kern DM; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
  • Lee DY; Division of Psychiatry, Faculty of Brain Science, University College London, London, England.
  • Park RW; Division of Psychiatry, Faculty of Brain Science, University College London, London, England.
  • Jang JW; Real-World Solutions, IQVIA, Durham, North Carolina.
  • Chui CSL; Real-World Solutions, IQVIA, Durham, North Carolina.
  • Li J; Johnson & Johnson, New Brunswick, New Jersey.
  • Reich C; Janssen Research & Development, LLC, Horsham, Pennsylvania.
  • Man KKC; Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
  • Wong ICK; Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
JAMA Psychiatry ; 80(3): 211-219, 2023 03 01.
Article in English | MEDLINE | ID: covidwho-2208847
ABSTRACT
Importance Concerns have been raised that the use of antipsychotic medication for people living with dementia might have increased during the COVID-19 pandemic.

Objective:

To examine multinational trends in antipsychotic drug prescribing for people living with dementia before and during the COVID-19 pandemic. Design, Setting, and

Participants:

This multinational network cohort study used electronic health records and claims data from 8 databases in 6 countries (France, Germany, Italy, South Korea, the UK, and the US) for individuals aged 65 years or older between January 1, 2016, and November 30, 2021. Two databases each were included for South Korea and the US. Exposures The introduction of population-wide COVID-19 restrictions from April 2020 to the latest available date of each database. Main Outcomes and

Measures:

The main outcomes were yearly and monthly incidence of dementia diagnosis and prevalence of people living with dementia who were prescribed antipsychotic drugs in each database. Interrupted time series analyses were used to quantify changes in prescribing rates before and after the introduction of population-wide COVID-19 restrictions.

Results:

A total of 857 238 people with dementia aged 65 years or older (58.0% female) were identified in 2016. Reductions in the incidence of dementia were observed in 7 databases in the early phase of the pandemic (April, May, and June 2020), with the most pronounced reduction observed in 1 of the 2 US databases (rate ratio [RR], 0.30; 95% CI, 0.27-0.32); reductions were also observed in the total number of people with dementia prescribed antipsychotic drugs in France, Italy, South Korea, the UK, and the US. Rates of antipsychotic drug prescribing for people with dementia increased in 6 databases representing all countries. Compared with the corresponding month in 2019, the most pronounced increase in 2020 was observed in May in South Korea (Kangwon National University database) (RR, 2.11; 95% CI, 1.47-3.02) and June in the UK (RR, 1.96; 95% CI, 1.24-3.09). The rates of antipsychotic drug prescribing in these 6 databases remained high in 2021. Interrupted time series analyses revealed immediate increases in the prescribing rate in Italy (RR, 1.31; 95% CI, 1.08-1.58) and in the US Medicare database (RR, 1.43; 95% CI, 1.20-1.71) after the introduction of COVID-19 restrictions. Conclusions and Relevance This cohort study found converging evidence that the rate of antipsychotic drug prescribing to people with dementia increased in the initial months of the COVID-19 pandemic in the 6 countries studied and did not decrease to prepandemic levels after the acute phase of the pandemic had ended. These findings suggest that the pandemic disrupted the care of people living with dementia and that the development of intervention strategies is needed to ensure the quality of care.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antipsychotic Agents / Dementia / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Psychiatry Year: 2023 Document Type: Article Affiliation country: Jamapsychiatry.2022.4448

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antipsychotic Agents / Dementia / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Psychiatry Year: 2023 Document Type: Article Affiliation country: Jamapsychiatry.2022.4448