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. 2017 Mar 9;12(3):e0173450.
doi: 10.1371/journal.pone.0173450. eCollection 2017.

Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer's disease in 2005-2011

Anna-Maija Tolppanen  1   2 , Ari Voutilainen  3 , Heidi Taipale  1   4   5   6 , Antti Tanskanen  5   6   7 , Piia Lavikainen  1 , Marjaana Koponen  1   4 , Jari Tiihonen  5   6 , Sirpa Hartikainen  1   4   8
Affiliations

Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer's disease in 2005-2011

Anna-Maija Tolppanen et al. PLoS One. .

Abstract

Objectives: To describe and compare temporal changes in prevalence and incidence of psychotropic use (antipsychotics, antidepressants and benzodiazepines and related drugs; BZDRs) in persons with newly diagnosed Alzheimer's disease (AD) between university hospital districts of Finland during 2005-2011.

Methods: The MEDALZ study includes all community-dwellers of Finland who received a clinically verified AD diagnosis in 2005-2011 (N = 70,718). Prevalent and incident use of psychotropics among those who had received AD diagnosis less than one year ago were compared in 2005-2011.

Results: Regional differences in psychotropic use between university hospital districts were more evident in 2005 than 2011 for prevalent use of any psychotropic, antipsychotic and BZDRs and incident use of any psychotropic and antipsychotics. Regional differences in prevalent antidepressant use and incident BZDR use remained similar during the follow-up, while differences in incident antidepressant use increased during the follow-up. The prevalence of any psychotropic use in 2005 varied between 44.7-50.7% and between 45.0-47.9% in 2011. Incidence of any psychotropic use in 2005 was between 8.6-12.1% and 6.2-8.2% in 2011. In 2005, the distribution of incident psychotropic use followed a large scale spatial variation that, however, did not correspond to university hospital districts. During the study period from 2005 to 2011 the cyclic spatial variation disappeared. No sign of adjacent hospital districts being more or less closely related to each other compared to hospital districts in general was detected.

Conclusions: Except for antidepressants, regional differences in psychotropic use have mainly diminished between 2005 and 2011. Our findings highlight the importance of acknowledging regional differences in a country with relatively homogeneous healthcare system and conducting future studies assessing the reasons behind these differences.

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Conflict of interest statement

Competing Interests: JT has served as a consultant to Lundbeck, Organon, Janssen-Cilag, Eli Lilly, AstraZeneca, F. Hoffman-La Roche, and Bristol-Myers Squibb. He has received fees for giving expert opinions to Bristol-Myers Squibb and GlaxoSmithKline, lecture fees from Janssen-Cilag, Bristol-Myers Squibb, Eli Lilly, Pfizer, Lundbeck, GlaxoSmithKline, AstraZeneca and Novartis; and grant from Stanley Foundation. JT is a member of advisory board in AstraZeneca, Janssen-Cilag, and Otsuka. MK has received a personal research grant from Oy H. Lundbeck Ab foundation outside the submitted work. SH has received a lecturing fee from MSD. HT and AT have participated in research projects funded by Janssen with grants paid to the institution where they were employed. Other authors declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1
The prevalence of a) any psychotropic b) antipsychtotic c) antidepressant and d) benzodiazepines and related drug (BZDR) use in different university hospital regions in 2005 and 2011.
Fig 2
Fig 2
Incidence of any psychotropic use in different university hospital districts (a-b) and hospital districts (c-d; numbers correspond to those in S2 Table) in 2005 and 2011.
Fig 3
Fig 3
The incidence of a) any psychotropic b) antipsychtotic c)antidepressant and d) benzodiazepines and related drug (BZDR) use in different university hospital regions in 2005 and 2011.
Fig 4
Fig 4. Modelled spatial distribution of incident psychotropic use in 2005.
The model explained circa 30% of the actual distribution (see Fig 2). Red lines indicate borders of university hospital districts and numbering of hospital districts corresponds to S2 Table.
See this image and copyright information in PMC

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