Evidence map›Paper›PMID 30796116›Full record

ArticleBMJ open2019

Comparative risk of new-onset diabetes following commencement of antipsychotics in New Zealand: a population-based clustered multiple baseline time series design.

Olivia Currie, Jonathan Williman, Dee Mangin, Bianca McKinnon-Gee, Paul Bridgford

Abstract readComparative Study
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

5 authors.

Olivia CurrieDepartment of General Practice, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand.
Jonathan WillimanDepartment of Public Health, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand.
Dee ManginDepartment of General Practice, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand.ORCID 0000-0003-2149-9376
Bianca McKinnon-GeePegasus Health (Charitable), Christchurch, New Zealand.
Paul BridgfordPegasus Health (Charitable), Christchurch, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNewer antipsychotics are increasingly prescribed off-label for non-psychotic ailments both in primary and secondary care settings, despite the purported risk of weight gain and development of type 2 diabetes mellitus. This study aims to determine any relationship between the development of clinically significant new-onset type 2 diabetes mellitus and novel antipsychotic use in New Zealand using hypnotic drugs as control.

designA population-based clustered multiple baseline time series design.

settingRoutinely collected data from a complete national pharmaceutical database in New Zealand between 2005 and 2011.

participantsPatients aged 40-60 years in the year 2006 who were ever dispensed antipsychotics (exposure groups-first-generation antipsychotics, second-generation antipsychotics and antipsychotics with low, medium and high risk for weight gain) or hypnotics (control group) between 2006 and 2011.

main outcome measureFirst ever metformin dispensed to patients in each study group between 2006 and 2011 as proxy for development of clinically significant type 2 diabetes mellitus, no longer amendable by lifestyle modifications.

resultsPatients dispensed a second-generation antipsychotic had 1.49 times increased risk (95% CI 1.10 to 2.03, p=0.011) of subsequently commencing metformin. Patients dispensed an antipsychotic with high risk of weight gain also had a 2.41 times increased risk of commencing on metformin (95% CI 1.42 to 4.09, p=0.001).

conclusionsPatients dispensed a second-generation antipsychotic and antipsychotics with high risk of weight gain appear to be at increased risk of being secondarily dispensed metformin. Caution should be taken with novel antipsychotic use for patients with increased baseline risk of type 2 diabetes mellitus.

Indexed as

AdultAntipsychotic AgentsCluster AnalysisDiabetes Mellitus, Type 2FemaleHumansHypnotics and SedativesHypoglycemic AgentsMaleMetforminMiddle AgedRisk FactorsWeight GainAntipsychotic AgentsHypnotics and SedativesHypoglycemic AgentsMetforminantipsychoticsdiabeteselectronic prescriptionhypnoticsmetforminprimary care

Identifiers

PMID30796116
PMCPMC6398760

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

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.