Evidence map›Paper›PMID 32162240›Full record

ArticleAging clinical and experimental research2021

Initiation of antipsychotics after moving to residential aged care facilities and mortality: a national cohort study.

Stephanie L Harrison, Janet K Sluggett, Catherine Lang, Craig Whitehead, Maria Crotty, Megan Corlis, Steve Wesselingh, Maria C Inacio

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Article in Aging clinical and experimental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

8 authors.

Stephanie L HarrisonRegistry of Senior Australians, Health Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia. stephanie.harrison@liverpool.ac.uk.
Janet K SluggettRegistry of Senior Australians, Health Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
Catherine LangRegistry of Senior Australians, Health Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
Craig WhiteheadHelping Hand Aged Care, North Adelaide, SA, 5006, Australia.
Maria CrottyHelping Hand Aged Care, North Adelaide, SA, 5006, Australia.
Megan CorlisSouth Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
Steve WesselinghLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, Merseyside, L7 8TX, United Kingdom.
Maria C InacioRegistry of Senior Australians, Health Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a high burden of antipsychotic use in residential aged care facilities (RACFs) and there is concern regarding potential inappropriate prescribing of antipsychotics in response to mild behavioural symptoms. Antipsychotic use has been associated with a higher risk of mortality in community-dwelling older adults with dementia, but few studies have examined associations upon RACF entry.

aimsTo examine associations between incident antipsychotic use and risk of mortality for people with and without diagnosed dementia in RACFs.

methodsA retrospective cohort study, employing a new-user design (individuals did not receive an antipsychotic 6 months before enrolment) of 265,820 people who accessed RACFs in Australia between 1/4/2008 and 30/6/2015 was conducted. Cox regression models were used to examine adjusted associations between antipsychotic use in the first 100 days of RACF entry and mortality.

resultsIn the 100 days after entering care, 29,455 residents (11.1%) were dispensed an antipsychotic. 180,956 (68.1%) residents died [38,249 (14.4%) were related to cerebrovascular causes] over a median 2.1 years (interquartile range 1.0-3.6) follow-up. Of the residents included, 119,665 (45.0%) had a diagnosis of dementia. Incident antipsychotic use was associated with higher risk of mortality in residents with dementia (adjusted hazard ratio 1.20, 95% confidence interval 1.18-1.22) and without dementia (1.28, 1.24-1.31).

conclusionInitiation of antipsychotics after moving to RACFs is associated with a higher risk of mortality. Careful consideration of the potential benefits and harms should be given when starting a new prescription for antipsychotics for people moving to RACFs.

Indexed as

Antipsychotic AgentsDementiaAgedAustraliaCohort StudiesHumansRetrospective StudiesAntipsychotic AgentsAntipsychoticsDementiaMortalityNursing homes

Identifiers

PMID32162240
PMCPMC7897604

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