ArticlePloS one2013
Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001-2011.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Mixed Impact of Direct Healthcare Professional Communications When Considering Proximal Outcomes and the Targeted Population: A Systematic Review.Pharmacoepidemiology and drug safety · 2025Pooled it
- Quality of Reporting on the Evaluation of Risk Minimization Programs: A Systematic Review.Drug safety · 2020Pooled it
- Impact of medicines regulatory risk communications in the UK on prescribing and clinical outcomes: Systematic review, time series analysis and meta-analysis.British journal of clinical pharmacology · 2020Pooled it
- Measuring the impact of medicines regulatory interventions - Systematic review and methodological considerations.British journal of clinical pharmacology · 2018Pooled it
- What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses.Implementation science : IS · 2015Pooled it
- Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS): multicentre, three arm, cluster randomised controlled trial.BMJ (Clinical research ed.) · 2016Trial
- Should we, can we, halt the rise in prescribing for pain and distress?The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Impact of EMA regulatory label changes on systemic diclofenac initiation, discontinuation, and switching to other pain medicines in Scotland, England, Denmark, and The Netherlands.Pharmacoepidemiology and drug safety · 2020Article
- Article
- Reduction in Use of Risperidone for Dementia in Australia Following Changed Guidelines.Pharmacy (Basel, Switzerland) · 2019Article
- The Role of European Healthcare Databases for Post-Marketing Drug Effectiveness, Safety and Value Evaluation: Where Does Italy Stand?Drug safety · 2019Review
- Prescribing Variation in General Practices in England Following a Direct Healthcare Professional Communication on Mirabegron.Journal of clinical medicine · 2018Article
- Psychotropic and anti-dementia treatment in elderly persons with clinical signs of dementia with Lewy bodies: a cross-sectional study in 40 nursing homes in Sweden.BMC geriatrics · 2018Article
- Article
- Psychotropic Drug-Related Fall Incidents in Nursing Home Residents Living in the Eastern Part of The Netherlands.Drugs in R&D · 2017Article
- Inequalities in receipt of mental and physical healthcare in people with dementia in the UK.Age and ageing · 2017Article
- Article
- Antipsychotic use in dementia patients in a general practice setting: a Dutch population-based study.Epidemiology and psychiatric sciences · 2016Article
- The impact of dementia on drug costs in older people: results from the SNAC study.BMC neurology · 2016Article
- Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications.BMC medicine · 2014Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundRegulatory risk communications are an important method for disseminating drug safety information, but their impact varies. Two significant UK risk communications about antipsychotic use in older people with dementia were issued in 2004 and 2009. These varied considerably in their content and dissemination, allowing examination of their differential impact.
methodsSegmented regression time-series analysis 2001-2011 for people aged ≥65 years with dementia in 87 Scottish general practices, examining the impact of two pre-specified risk communications in 2004 and 2009 on antipsychotic and other psychotropic prescribing.
resultsThe percentage of people with dementia prescribed an antipsychotic was 15.9% in quarter 1 2001 and was rising by an estimated 0.6%/quarter before the 2004 risk communication. The 2004 risk communication was sent directly to all prescribers, and specifically recommended review of all patients prescribed relevant drugs. It was associated with an immediate absolute reduction in antipsychotic prescribing of 5.9% (95% CI -6.6 to -5.2) and a change to a stable level of prescribing subsequently. The 2009 risk communication was disseminated in a limited circulation bulletin, and only specifically recommended avoiding initiation if possible. There was no immediate associated impact, but it was associated with a significant decline in prescribing subsequently which appeared driven by a decline in initiation, with the percentage prescribed an antipsychotic falling from 18.4% in Q1 2009 to 13.5% in Q1 2011. There was no widespread substitution of antipsychotics with other psychotropic drugs.
conclusionsThe two risk communications were associated with reductions in antipsychotic use, in ways which were compatible with marked differences in their content and dissemination. Further research is needed to ensure that the content and dissemination of regulatory risk communications is optimal, and to track their impact on intended and unintended outcomes. Although rates are falling, antipsychotic prescribing in dementia in Scotland remains unacceptably high.
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