Details
Original language | English |
---|---|
Article number | 841 |
Journal | Frontiers in Pharmacology |
Volume | 10 |
Early online date | 24 Jul 2019 |
Publication status | Published - Jul 2019 |
Abstract
Objective: A restrictive use of tricyclic antidepressants (TCA) in patients with dementia (PwD) is recommended due to the hazard of anticholinergic side effects. We evaluated the frequency of TCA dispensing in PwD over a period of 1 year and the use of TCA before and after the incident diagnosis of dementia. Methods: This analysis was based on administrative data from a German statutory health insurance for a period of 2 years. Totally, 20,357 patients with an incident diagnosis of dementia in 2014 were included. We evaluated the dispensing of TCA in 2015. Subgroup analyses were conducted to evaluate associations between the incident diagnosis of dementia and modifications in TCA dispensing. Results: In 2015, 1,125 dementia patients (5.5%) were treated with TCA and 31% were medicated with TCA in all four quarters of 2015. Most dispensings were conducted by general practitioners (67.9%). On average, patients received 3.7 ± 2.6 dispensings per year. Amitriptyline (56.3%), doxepin (26.8%), and trimipramine (16.8%) were dispensed most often. Subgroup analyses revealed that the dispensing of TCA remained mainly unchanged following the incident diagnosis. Conclusion: A relevant number of PwD were treated with TCA. To maintain the patients' safety, an improved implementation of guidelines for the pharmaceutical treatment of PwD in healthcare institutions might be required. Since 68% of the patients suffered from depression, future studies should further evaluate the indications for TCA.
Keywords
- Antidepressants, Claims data, Dementia, Pharmacotherapy, Tricyclic
ASJC Scopus subject areas
- Pharmacology, Toxicology and Pharmaceutics(all)
- Pharmacology
- Medicine(all)
- Pharmacology (medical)
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In: Frontiers in Pharmacology, Vol. 10, 841, 07.2019.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Claims Data Analysis on the Dispensing of Tricyclic Antidepressants Among Patients with Dementia in Germany
AU - Hessmann, Philipp
AU - Zeidler, Jan
AU - Stahmeyer, Jona
AU - Eberhard, Sveja
AU - Vogelgsang, Jonathan
AU - Abdel-Hamid, Mona
AU - Wolff-Menzler, Claus
AU - Wiltfang, Jens
AU - Kis, Bernhard
N1 - Funding information: The authors would like to thank all colleagues at the CHERH assisting with the data analysis. Especially, the authors would like to thank the Research School for Translational Medicine at the University Medical Center in Goettingen (Goettinger Kolleg für Translationale Medizin) and the Lower Saxony Ministry of Science and Culture (Niedersaechsisches Ministerium für Wissenschaft und Kultur) for supporting this research project. We acknowledge support by the German Research Foundation and the Open Access Publication Funds of the Goettingen University. We would like to thank Editage (www.editage.com) for English language editing.
PY - 2019/7
Y1 - 2019/7
N2 - Objective: A restrictive use of tricyclic antidepressants (TCA) in patients with dementia (PwD) is recommended due to the hazard of anticholinergic side effects. We evaluated the frequency of TCA dispensing in PwD over a period of 1 year and the use of TCA before and after the incident diagnosis of dementia. Methods: This analysis was based on administrative data from a German statutory health insurance for a period of 2 years. Totally, 20,357 patients with an incident diagnosis of dementia in 2014 were included. We evaluated the dispensing of TCA in 2015. Subgroup analyses were conducted to evaluate associations between the incident diagnosis of dementia and modifications in TCA dispensing. Results: In 2015, 1,125 dementia patients (5.5%) were treated with TCA and 31% were medicated with TCA in all four quarters of 2015. Most dispensings were conducted by general practitioners (67.9%). On average, patients received 3.7 ± 2.6 dispensings per year. Amitriptyline (56.3%), doxepin (26.8%), and trimipramine (16.8%) were dispensed most often. Subgroup analyses revealed that the dispensing of TCA remained mainly unchanged following the incident diagnosis. Conclusion: A relevant number of PwD were treated with TCA. To maintain the patients' safety, an improved implementation of guidelines for the pharmaceutical treatment of PwD in healthcare institutions might be required. Since 68% of the patients suffered from depression, future studies should further evaluate the indications for TCA.
AB - Objective: A restrictive use of tricyclic antidepressants (TCA) in patients with dementia (PwD) is recommended due to the hazard of anticholinergic side effects. We evaluated the frequency of TCA dispensing in PwD over a period of 1 year and the use of TCA before and after the incident diagnosis of dementia. Methods: This analysis was based on administrative data from a German statutory health insurance for a period of 2 years. Totally, 20,357 patients with an incident diagnosis of dementia in 2014 were included. We evaluated the dispensing of TCA in 2015. Subgroup analyses were conducted to evaluate associations between the incident diagnosis of dementia and modifications in TCA dispensing. Results: In 2015, 1,125 dementia patients (5.5%) were treated with TCA and 31% were medicated with TCA in all four quarters of 2015. Most dispensings were conducted by general practitioners (67.9%). On average, patients received 3.7 ± 2.6 dispensings per year. Amitriptyline (56.3%), doxepin (26.8%), and trimipramine (16.8%) were dispensed most often. Subgroup analyses revealed that the dispensing of TCA remained mainly unchanged following the incident diagnosis. Conclusion: A relevant number of PwD were treated with TCA. To maintain the patients' safety, an improved implementation of guidelines for the pharmaceutical treatment of PwD in healthcare institutions might be required. Since 68% of the patients suffered from depression, future studies should further evaluate the indications for TCA.
KW - Antidepressants
KW - Claims data
KW - Dementia
KW - Pharmacotherapy
KW - Tricyclic
UR - http://www.scopus.com/inward/record.url?scp=85069782664&partnerID=8YFLogxK
U2 - 10.3389/fphar.2019.00841
DO - 10.3389/fphar.2019.00841
M3 - Article
AN - SCOPUS:85069782664
VL - 10
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
SN - 1663-9812
M1 - 841
ER -