Evidence map›Paper›PMID 28439716›Full record

ArticleDrug safety2017

Antipsychotic Prescribing to Patients Diagnosed with Dementia Without a Diagnosis of Psychosis in the Context of National Guidance and Drug Safety Warnings: Longitudinal Study in UK General Practice.

S Jill Stocks, Evangelos Kontopantelis, Roger T Webb, Anthony J Avery, Alistair Burns, Darren M Ashcroft

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
3.0field-weighted citation impact, top 10% 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

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

S Jill StocksDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health Research Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, University of Manchester, Manchester, UK. jill.stocks@manchester.ac.uk.
Evangelos KontopantelisDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health Research School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester, UK.
Roger T WebbDivision of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK.
Anthony J AveryDivision of Primary Care, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
Alistair BurnsDivision of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, UK.
Darren M AshcroftDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health Research Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, University of Manchester, Manchester, UK.
National Institute for Health Research · GBManchester Academic Health Science Centre · GBQueen's Medical Centre · GBUniversity of Manchester · GB

Funding

Department of Health GMPSTRC-2012-1Department of Health RP-PG-1214-20012Medical Research Council MR/K006665/1
6 · The paper itself

Abstract

introductionPolicy interventions to address inappropriate prescribing of antipsychotic drugs to older people diagnosed with dementia are commonplace. In the UK, warnings were issued by the Medicines Healthcare products Regulatory Agency in 2004, 2009 and 2012 and the National Institute for Health and Care Excellence guidance was published in 2006. It is important to evaluate the impact of such interventions.

methodsWe analysed routinely collected primary-care data from 111,346 patients attending one of 689 general practices contributing to the Clinical Practice Research Datalink to describe the temporal changes in the prescribing of antipsychotic drugs to patients aged 65 years or over diagnosed with dementia without a concomitant psychosis diagnosis from 2001 to 2014 using an interrupted time series and a before-and-after design. Logistic regression methods were used to quantify the impact of patient and practice level variables on prescribing prevalence.

resultsPrescribing of first-generation antipsychotic drugs reduced from 8.9% in 2001 to 1.4% in 2014 (prevalence ratio 2014/2001 adjusted for age, sex and clustering within practices (0.14, 95% confidence interval 0.12-0.16), whereas there was little change for second-generation antipsychotic drugs (1.01, confidence interval 0.94-1.17). Between 2004 and 2012, several policy interventions coincided with a pattern of ups and downs, whereas the 2006 National Institute for Health and Care Excellence guidance was followed by a gradual longer term reduction. Since 2013, the decreasing trend in second-generation antipsychotic drug prescribing has plateaued largely driven by the increasing prescribing of risperidone.

conclusionsIncreased surveillance and evaluation of drug safety warnings and guidance are needed to improve the impact of future interventions.

Indexed as

Practice Guidelines as TopicAgedAged, 80 and overAntipsychotic AgentsCross-Sectional StudiesDementiaFemaleHumansInappropriate PrescribingInterrupted Time Series AnalysisLongitudinal StudiesMalePolypharmacyPractice Patterns, Physicians'Residence CharacteristicsRisk FactorsAntipsychotic Agents

Identifiers

PMID28439716
PMCPMC5519656
OpenAlexW2609963590

What OpenQuestion holds

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Registered trials

None linked

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.