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Dhawan N, Steele AB, Morgan RO, et al. Documentation of antipsychotic use and indications for newly diagnosed, nonaggressive dementia patients. Prim Care Companion J Clin Psychiatry. 2008;10(2):97-102doi: 10.4088/pcc.v10n0202.
Dhawan, N., Steele, A. B., Morgan, R. O., Snow, A. L., Davila, J. A., & Kunik, M. E. (2008). Documentation of antipsychotic use and indications for newly diagnosed, nonaggressive dementia patients. Primary care companion to the Journal of clinical psychiatry, 10(2), 97-102. https://doi.org/10.4088/pcc.v10n0202
Dhawan, Nikhil, et al. "Documentation of antipsychotic use and indications for newly diagnosed, nonaggressive dementia patients." Primary care companion to the Journal of clinical psychiatry vol. 10,2 (2008): 97-102. doi: https://doi.org/10.4088/pcc.v10n0202
Dhawan N, Steele AB, Morgan RO, Snow AL, Davila JA, Kunik ME. Documentation of antipsychotic use and indications for newly diagnosed, nonaggressive dementia patients. Prim Care Companion J Clin Psychiatry. 2008;10(2):97-102. doi: 10.4088/pcc.v10n0202. PMID: 18458729; PMCID: PMC2292442.
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Prim Care Companion J Clin Psychiatry. 2008;10(2):97-102. doi: 10.4088/pcc.v10n0202.

Documentation of antipsychotic use and indications for newly diagnosed, nonaggressive dementia patients.

Primary care companion to the Journal of clinical psychiatry

Nikhil Dhawan, Avila B Steele, Robert O Morgan, A Lynn Snow, Jessica A Davila, Mark E Kunik

Affiliations

  1. Houston Center for Quality of Care and Utilization Studies, Health Services Research, Houston, TX, USA.

PMID: 18458729 PMCID: PMC2292442 DOI: 10.4088/pcc.v10n0202

Abstract

OBJECTIVE: The purpose of this study was to determine the prevalence of antipsychotic use among nonaggressive patients with newly diagnosed dementia and to examine indications for antipsychotic use.

METHOD: Patients had to be veterans older than 60 years, newly diagnosed with dementia (ICD-9-CM criteria) from 2001 to 2004 at the Michael A. DeBakey Veterans Affairs Medical Center in Houston, Tex. Patients diagnosed more than 1 year before telephone screening, living in a nursing home or having a caregiver less than 8 hours a week, and/or having aggression, determined by caregiver response on the Ryden Aggression Scale, were excluded. Medical records of eligible participants were then evaluated on the basis of 5 questions: (1) Was the patient taking an antipsychotic? (2) Were neuropsychiatric symptoms documented, with or without antipsychotics? (3) Did the patient have comorbid psychiatric diagnoses? (4) Did the physician attempt to decrease or discontinue the antipsychotic? and (5) Did the physician attempt non-pharmacologic interventions?

RESULTS: A total of 173 patients were eligible for medical record evaluation. Of these, 29 (17%) had been prescribed antipsychotics. Depression, nighttime disturbance, and irritability were the most often documented neuropsychiatric symptoms; however, 31% of patients had no documented symptoms. Mood disorder was documented in 36% of patient records; however, 94 patients (54%) had no comorbid psychiatric disorder. Twelve nonpharmacologic interventions were documented for dementia symptoms. Only 2 attempts to discontinue or decrease antipsychotics for the 29 patients using them were documented.

CONCLUSION: A sizable minority of newly diagnosed, nonaggressive dementia patients are taking antipsychotics. Physicians need greater education and awareness of the benefits of nonpharmacologic interventions.

References

  1. Int Psychogeriatr. 2002 Jun;14(2):197-210 - PubMed
  2. J Am Geriatr Soc. 2003 Sep;51(9):1287-98 - PubMed
  3. Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):115-21 - PubMed
  4. J Am Geriatr Soc. 2003 Jun;51(6):869-73 - PubMed
  5. Alzheimer Dis Assoc Disord. 2001 Oct-Dec;15(4):169-73 - PubMed
  6. Alzheimer Dis Assoc Disord. 1988;2(4):342-55 - PubMed
  7. J Am Geriatr Soc. 2004 Oct;52(10):1737-43 - PubMed
  8. Am J Geriatr Psychiatry. 2005 Aug;13(8):722-30 - PubMed
  9. Am J Psychiatry. 2005 Nov;162(11):1996-2021 - PubMed
  10. J Neuropsychiatry Clin Neurosci. 2000 Spring;12(2):233-9 - PubMed
  11. Int J Geriatr Psychiatry. 2004 Nov;19(11):1035-9 - PubMed
  12. Arch Psychiatr Nurs. 2006 Oct;20(5):217-25 - PubMed
  13. N Engl J Med. 2006 Oct 12;355(15):1604-6 - PubMed
  14. Arch Intern Med. 2007 Apr 9;167(7):676-83 - PubMed
  15. Int J Geriatr Psychiatry. 2006 Oct;21(10):972-6 - PubMed
  16. Neurology. 1994 Dec;44(12):2308-14 - PubMed
  17. Pharmacoeconomics. 2005;23(3):227-42 - PubMed
  18. Arch Intern Med. 1999 Aug 9-23;159(15):1733-40 - PubMed
  19. Arch Intern Med. 2006 Nov 13;166(20):2182-8 - PubMed
  20. Am J Psychiatry. 1997 May;154(5 Suppl):1-39 - PubMed
  21. Am J Geriatr Psychiatry. 2006 Jul;14(7):561-72 - PubMed
  22. Postgrad Med. 2005 Jan;Spec No:6-22 - PubMed
  23. Neurology. 1999 Mar 10;52(4):714-8 - PubMed
  24. N Engl J Med. 2006 Oct 12;355(15):1525-38 - PubMed

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