ArticleDrug safety2011
Risk of hospitalization for hip fracture and pneumonia associated with antipsychotic prescribing in the elderly: a self-controlled case-series analysis in an Australian health care claims database.
Article in Drug safety, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Biological substantiation of antipsychotic-associated pneumonia: Systematic literature review and computational analyses.PloS one · 2017Pooled it
- Choice of observational study design impacts on measurement of antipsychotic risks in the elderly: a systematic review.BMC medical research methodology · 2012Pooled it
- Impact of on-site pharmacists in residential aged care facilities on the quality of medicines use: a cluster randomised controlled trial (PiRACF study).Scientific reports · 2023Trial
- The Association Between Antipsychotics and Bone Fragility: An Updated Comprehensive Review.Diagnostics (Basel, Switzerland) · 2024Review
- Antipsychotic medication use and fracture: a case-control study.Scientific reports · 2023Article
- Adverse events with quetiapine and clarithromycin coprescription: A population-based retrospective cohort study.Health science reports · 2023Article
- Quality Use of Medicines Indicators and Associated Factors in Residential Aged Care Facilities: Baseline Findings from the Pharmacists in RACF Study in Australia.Journal of clinical medicine · 2022Article
- The Association Between Antihypertensive Drug Use and Hospitalization for Pneumonia in the General Population: A Case-Crossover Study Using the National Health Insurance Database of Korea.Journal of Korean medical science · 2022Article
- Generating Real-World Evidence on the Quality Use, Benefits and Safety of Medicines in Australia: History, Challenges and a Roadmap for the Future.International journal of environmental research and public health · 2021Review
- Use of antipsychotic drugs and cholinesterase inhibitors and risk of falls and fractures: self-controlled case series.BMJ (Clinical research ed.) · 2021Observational
- Association between Anti-Psychotic Drugs Use and Hip Fractures in Patients with Dementia: A Nationwide Population-Based Study.International journal of environmental research and public health · 2021Article
- Article
- Exploring a Safety Signal of Antipsychotic-Associated Pneumonia: A Pharmacovigilance-Pharmacodynamic Study.Schizophrenia bulletin · 2021Article
- An Analysis of Psychoactive Medications Initiated in the ICU but Continued Beyond Discharge: A Pilot Study of Stewardship.Journal of pharmacy practice · 2020Observational
- Policy to Reduce Antipsychotic Use and Hospitalization of Nursing Home Residents With Dementia.Journal of the American Medical Directors Association · 2020Observational
- Psychotropic Drug-Associated Pneumonia in Older Adults.Drugs & aging · 2020Review
- Initiation and continuation of antipsychotic medicines in older people following non-psychiatric hospital admission.International journal of clinical pharmacy · 2019Article
- Reduction in Use of Risperidone for Dementia in Australia Following Changed Guidelines.Pharmacy (Basel, Switzerland) · 2019Article
- Use of Potentially Inappropriate Medications in People With Dementia in Vietnam and Its Associated Factors.American journal of Alzheimer's disease and other dementias · 2018Article
- Antipsychotics and the Risk of Aspiration Pneumonia in Individuals Hospitalized for Nonpsychiatric Conditions: A Cohort Study.Journal of the American Geriatrics Society · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntipsychotics are commonly used in the elderly to treat the behavioural symptoms of dementia. Randomized controlled trial data on the safety of antipsychotics are limited and little is known about the long-term effects of these medicines. Observational studies have investigated the risk of hip fracture and pneumonia associated with the use of antipsychotics, but varying results may be due to lack of control for unmeasured confounding.
objectiveThe aim of the study was to investigate the risk of hospitalization for hip fracture and pneumonia in elderly subjects exposed to antipsychotic medication using the self-controlled case-series design to control for unmeasured confounding.
methodsThe source of data for this study was the Australian Government Department of Veterans' Affairs Health Care Claims Database. A self-controlled case-series design was used to measure the excess risk of hospitalization for hip fracture and pneumonia after antipsychotic exposure compared with no-exposure over the 4-year period from 2005 to 2008.
resultsThere was a significantly increased risk of hip fracture 1 week after exposure to typical antipsychotics, and the risk remained significantly raised with >12 weeks of continuous exposure (incidence rate ratio [IRR] 2.19; 95% CI 1.62, 2.95). The risk of hip fracture was highest in the first week after initiation of atypical antipsychotics (IRR 2.17; 95% CI 1.54, 3.06). The risk then declined with longer-term treatment; however, it remained significantly raised with >12 weeks of continuous exposure (IRR 1.43; 95% CI 1.23, 1.66). The risk of hospitalization for pneumonia was raised in all post-exposure periods for both typical and atypical antipsychotics.
conclusionsAntipsychotic use in the elderly is associated with an increased risk of hospitalization for hip fracture and pneumonia. Given the increased risks of morbidity and mortality associated with these outcomes, practitioners should consider these additional risks when prescribing antipsychotics to treat behavioural symptoms of dementia in the elderly.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.