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- Title
Incidence, prescription patterns and risk factors of antipsychotic initiation in elderly stroke survivors.
- Authors
Chien‐Chou Su; Yea‐Huei Kao Yang; Ching‐Lan Cheng; Chia‐Cheng Lai, Edward; Cheng‐Yang Hsieh; Chih‐Hung Chen; Huey‐Juan Lin; Sheng‐Feng Sung; Yu‐Wei Chen
- Abstract
Objectives: Epidemiological data regarding antipsychotic initiation in elderly patients with stroke are limited. We aimed to investigate the incidence, prescription patterns and determinants of antipsychotic initiation in elderly patients with stroke. Methods: We conducted a retrospective cohort study to identify patients aged above 65 years who had been admitted for stroke from the National Health Insurance Database (NHID). The index date was defined as the discharge date. The incidence and prescription pattern of antipsychotics were estimated using the NHID. To evaluate the determinants of antipsychotic initiation, the cohort identified from the NHID was linked to the Multicenter Stroke Registry (MSR). Demographics, comorbidities and concomitant medications were obtained from the NHID. Information including smoking status, body mass index, stroke severity and disability was retrieved by linking to the MSR. The outcome was antipsychotic initiation after the index date. Hazard ratios for antipsychotic initiation were estimated using the multivariable Cox model. Results: In terms of prognosis, the first 2 months after a stroke was the highest‐risk period for antipsychotic use. A high burden of coexisting diseases carried an increased risk of antipsychotic use; in particular, chronic kidney disease (CKD) had the highest adjusted hazard ratio (aHR = 1.73; 95% CI 1.29–2.31) as compared with other risk factors. Furthermore, stroke severity and disability were significant risk factors for antipsychotic initiation. Conclusions: Our study indicated that elderly stroke patients with chronic medical conditions, particularly CKD, and a higher stroke severity and disability were at greater risk of psychiatric disorders during the first 2 months after a stroke. Clinical trial registration: NA.
- Subjects
STROKE risk factors; CHRONIC kidney failure; STROKE; MULTIVARIATE analysis; RETROSPECTIVE studies; ACQUISITION of data; RISK assessment; SEVERITY of illness index; DRUG prescribing; MEDICAL records; PHYSICIAN practice patterns; SMOKING; BODY mass index; ANTIPSYCHOTIC agents; LONGITUDINAL method; PROPORTIONAL hazards models; OLD age
- Publication
International Journal of Geriatric Psychiatry, 2023, Vol 38, Issue 3, p1
- ISSN
0885-6230
- Publication type
Article
- DOI
10.1002/gps.5892