Evidence map›Paper›PMID 27398376›Full record

ArticleCMAJ open

Trends in the use and cost of antipsychotics among older adults from 2007 to 2013: a repeated cross-sectional study.

Paul D Foster, Ximena Camacho, Simone Vigod, Zhan Yao, David N Juurlink, J Michael Paterson, Muhammad M Mamdani, Diana Martins, Tara Gomes

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Paul D FosterSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Ximena CamachoSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Simone VigodSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Zhan YaoSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
David N JuurlinkSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
J Michael PatersonSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Muhammad M MamdaniSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Diana MartinsSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
Tara GomesSchulich School of Medicine and Dentistry (Foster), Western University, London; Institute for Clinical Evaluative Sciences (Camacho, Vigod, Yao, Juurlink, Paterson, Mamdani, Martins, Gomes), Toronto; Applied Health Research Centre (Foster, Mamdani, Gomes), St. Michael's Hospital, Toronto; Women's College Hospital and Research Institute (Vigod), Toronto; Departments of Medicine (Juurlink)and Psychiatry (Vigod) and Institute of Health Policy, Management and Evaluation (Vigod, Juurlink, Paterson, Mamdani, Gomes), University of Toronto, Toronto; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont. Paul Foster, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes conceived the study. Ximena Camacho, Zhan Yao and Diana Martins acquired the data. Paul Foster and Tara Gomes drafted the manuscript, and Simone Vigod, David Juurlink, Michael Paterson, Muhammad Mamdani and Tara Gomes revised the manuscript for important intellectual content. All of the authors designed the study, contributed to data analysis and interpretation, gave approval of the final version to be published and agreed to act as guarantors of the work.
St Michaels Hospital · GBInstitute for Clinical Evaluative Sciences · CASt. Michael's Hospital · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecently, several new atypical antipsychotic agents have been introduced in Ontario, and regulatory warnings have been issued regarding use of atypical antipsychotics in older adults. We sought to establish the impact of newer atypical antipsychotics on prescribing rates and costs.

methodsWe performed a population-based cross-sectional study of Ontario adults aged 65 years or more using atypical antipsychotics from Jan. 1, 2007, to Mar. 31, 2013. These people have universal access to publicly funded drugs through the Ontario Health Insurance Plan and the Ontario Drug Benefit. We conducted time-series analysis to assess the impact of the introduction of new atypical antipsychotics on rates of use of atypical antipsychotics and associated expenditures.

resultsRates of atypical antipsychotic use increased following the introduction of new agents in 2009, from 27.6 users per 1000 older adults in the third quarter of 2009 to 29.1 users per 1000 older adults at the end of the study period (p = 0.04). Although prescribing rates for the newer atypical agents (paliperidone, ziprasidone and aripiprazole) remained low relative to their older counterparts (risperidone, olanzapine and quetiapine), rates of aripiprazole use rose to 1.0 user per 1000 older adults by the end of the study period. The proportion of prescriptions that were for brand-name agents fell from 57.5% in the second quarter of 2007 to 6.1% in the second quarter of 2009, and then rose to 11.7% by the end of the study period. By the first quarter of 2013, newer atypical antipsychotic agents were used by 4.4% of atypical antipsychotic users but accounted for 14.1% ($1.2 million of $8.5 million) of atypical antipsychotic expenditures.

interpretationAlthough the overall prevalence of use of new atypical antipsychotic agents remains low, their introduction has led to increased prescribing of this class of drugs in older adults. Given the potential cost implications, further study of these trends would be prudent.

Identifiers

PMID27398376
PMCPMC4933600
OpenAlexW2412277495

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Registered trials

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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.