[High Prevalence of Antipsychotic Medication Use in Dementia Patients in German Neuropsychiatric Practices].

Background  The aim of the present study was to examine inpatients as well as patients living at home with respect to the frequency of antipsychotic medication use and to determine the factors leading to initial use of antipsychotics following dementia diagnosis. Methods  This study included patients aged 60 years and over with an initial diagnosis of all-cause dementia (index date) by German psychiatrists in Disease Analyzer database (IMS Health). The main outcome measure was the proportion of patients who initially received an antipsychotic prescription after the index date. Kaplan-Meier analyses were performed for studying time to initiation of antipsychotic therapy as a function of age and residence in nursing homes. A Cox proportional hazards regression model was used to estimate the relation between the likelihood of therapy initiation and the predefined demographical/clinical variables. Results  14 915 patients with dementia (mean age 80.3 years, 34.7 % male, 53.3 % residents of nursing homes) were included in this study. Within two years after the index date, 47.7 % patients with dementia were treated with antipsychotics. Residing in nursing homes, private insurance status, higher age, private health insurance, exhibiting mental disorders due to known physiological condition, personality and behavioral disorders due to known physiological condition, vascular dementia, and symptoms and signs involving emotional state were positively associated with therapy initiation. Conclusion  The prevalence of antipsychotic drug therapy in dementia patients, particularly in nursing homes, is very high. Further studies including qualitative research are required in order to understand and explain the reasons for this prescribing behavior.