Utilización de fármacos antipsicóticos atípicos en ancianos institucionalizados y prevalencia de alteraciones metabólicas / Utilisation of atypical antipsychotic drugs in institutionalised elderly persons and prevalence of metabolic alterations

Objetivos Describir y evaluar la utilización de antipsicóticos atípicos en la población anciana institucionalizada de la Comunidad Valenciana y la prevalencia de alteraciones metabólicas asociadas. Material y métodos Estudio multicéntrico, descriptivo y transversal de utilización de medicamentos y caso-control de la prevalencia de las alteraciones de la glucemia, colesterol y triglicéridos. El análisis estadístico de las alteraciones metabólicas se realiza a partir de la diferencia de prevalencia y su significación estadística entre el grupo control y estudio. Resultados Se incluyen 681 pacientes (grupo estudio: 344; grupo control: 337) de 20 centros sociosanitarios. El 18,5% de los pacientes institucionalizados está en tratamiento con antipsicóticos atípicos. Los diagnósticos más frecuentes son alteraciones de conducta asociada a la demencia (63,6%) y a la esquizofrenia (18,4%). La risperidona es el fármaco antipsicótico más utilizado (66,0%). En general, para todos los fármacos, las dosis utilizadas se ajustan a las recomendadas en el paciente anciano. La prevalencia de alteraciones en el metabolismo de la glucosa, el colesterol y los triglicéridos en el grupo de estudio es del 23,96, el 34,83 y el 26,29%, respectivamente, no encontrándose diferencias estadísticamente significativas con respecto al grupo control. El análisis por tipo de fármaco no muestra diferencias significativas. Conclusiones Los resultados obtenidos muestran que la utilización de antipsicóticos atípicos en el paciente anciano sigue en líneas generales las recomendaciones establecidas. Las dosis utilizadas en el paciente anciano con alteraciones de conducta asociadas a la demencia, mayoritariamente tratado con risperidona, no tienen un impacto significativo sobre el aumento de la prevalencia de alteraciones metabólicas (AU)

Objectives Describe and evaluate atypical antipsychotics utilisation on the institutionalized elderly population of the Valencian Community and prevalence of associated metabolic alterations. Material and methods Multicentre transversal descriptive study on medication utilisation and prevalence case-control of alterations of glycaemia, cholesterol and triglycerides. The statistical analysis of metabolic alterations is performed from the difference in prevalence and its statistical signification between the control group and the study group.Results681 patients were included (study group, 344; control group, 337) from 20 social-health-care centres. 18.5% of the institutionalised patients are being treated with atypical antipsychotics. The most frequent diagnoses are: behavioural alterations associated with dementia (63.6%) and schizophrenia (18.4%). Risperidone is the most frequently used antipsychotic (66.0%). For all the drugs in general the doses used adjust to those recommended for elderly patients. The prevalence of alterations in glycaemia, cholesterol and triglycerides metabolism in the group under study is 23.96%, 34.83%, and 26.29%, respectively, with no statistically significant differences against the control group. The analysis by type of drug did not show significant differences. Conclusions The results obtained show that utilisation of atypical antipsychotics in elderly patients complies with the established general recommendations. The doses used in elderly patients with behavioural alterations associated with dementia, mostly treated with risperidone, do not have a significant impact over prevalence increase of metabolic alterations (AU)

[Utilisation of atypical antipsychotic drugs in institutionalised elderly persons and prevalence of metabolic alterations]. / Utilización de fármacos antipsicóticos atípicos en ancianos institucionalizados y prevalencia de alteraciones metabólicas.

OBJECTIVES: Describe and evaluate atypical antipsychotics utilisation on the institutionalized elderly population of the Valencian Community and prevalence of associated metabolic alterations. MATERIAL AND METHODS: Multicentre transversal descriptive study on medication utilisation and prevalence case-control of alterations of glycaemia, cholesterol and triglycerides. The statistical analysis of metabolic alterations is performed from the difference in prevalence and its statistical signification between the control group and the study group. RESULTS: 681 patients were included (study group, 344; control group, 337) from 20 social-health-care centres. 18.5% of the institutionalised patients are being treated with atypical antipsychotics. The most frequent diagnoses are: behavioural alterations associated with dementia (63.6%) and schizophrenia (18.4%). Risperidone is the most frequently used antipsychotic (66.0%). For all the drugs in general the doses used adjust to those recommended for elderly patients. The prevalence of alterations in glycaemia, cholesterol and triglycerides metabolism in the group under study is 23.96%, 34.83%, and 26.29%, respectively, with no statistically significant differences against the control group. The analysis by type of drug did not show significant differences. CONCLUSIONS: The results obtained show that utilisation of atypical antipsychotics in elderly patients complies with the established general recommendations. The doses used in elderly patients with behavioural alterations associated with dementia, mostly treated with risperidone, do not have a significant impact over prevalence increase of metabolic alterations.