Table 1.
Selected characteristics in residents starting antipsychotic drugs during stay in nursing home. Figures are numbers (percentage) or means
| Haloperidol (n=5904) | Aripiprazole (n=1849) | Olanzapine (n=22 919) | Quetiapine (n=15 776) | Risperidone (n=27 936) | Ziprasidone (n=1061) | |
|---|---|---|---|---|---|---|
| High dose* | 2056/3507 (58.6) | 1501/1739 (86.3) | 9461/21 296 (44.4) | 7376/14 694 (50.2) | 2498/25 033 (10.0) | 630/924 (68.2) |
| Region: | ||||||
| Northeast | 648 (11.0) | 332 (18.0) | 3816 (16.6) | 2801 (17.8) | 4577 (16.4) | 47 (4.4) |
| Midwest | 1904 (32.2) | 607 (32.8) | 6582 (28.7) | 4430 (28.1) | 8749 (31.3) | 253 (23.8) |
| South | 2531 (42.9) | 764 (41.3) | 8976 (39.2) | 6952 (44.1) | 11 419 (40.9) | 695 (65.5) |
| West | 821 (13.9) | 146 (7.9) | 3545 (15.5) | 1593 (10.1) | 3191 (11.4) | 66 (6.2) |
| Rural (v urban) setting | 2508 (42.5) | 519 (28.1) | 7255 (31.7) | 4753 (30.1) | 9938 (35.6) | 512 (48.3) |
| Demographics: | ||||||
| Male | 1659 (28.1) | 508 (27.5) | 5555 (24.2) | 4028 (25.5) | 6858 (24.5) | 302 (28.5) |
| Mean age (years) | 83.8 | 81.9 | 83.5 | 83.0 | 83.7 | 82.6 |
| White race | 4730 (80.1) | 1473 (79.7) | 18 969 (82.8) | 13 015 (82.5) | 22 983 (82.3) | 851 (80.2) |
| Psychiatric morbidity: | ||||||
| Dementia | 3281 (55.6) | 1164 (63.0) | 13 418 (58.5) | 9668 (61.3) | 16 899 (60.5) | 655 (61.7) |
| Depression | 1407 (23.8) | 701 (37.9) | 6915 (30.2) | 5251 (33.3) | 7900 (28.3) | 371 (35.0) |
| Anxiety | 168 (2.8) | 42 (2.3) | 752 (3.3) | 524 (3.3) | 811 (2.9) | 45 (4.2) |
| Delirium | 373 (6.3) | 132 (7.1) | 1315 (5.7) | 1169 (7.4) | 1705 (6.1) | 93 (8.8) |
| Psychotic disorder | 623 (10.6) | 244 (13.2) | 2400 (10.5) | 1800 (11.4) | 3053 (10.9) | 165 (15.6) |
| Impairment in cognitive function: | ||||||
| Intact to moderate | 846 (14.3) | 330 (17.8) | 3578 (15.6) | 2331 (14.8) | 4049 (14.5) | 180 (17.0) |
| Moderate to severe | 3252 (55.1) | 1093 (59.1) | 13 036 (56.9) | 8963 (56.8) | 15 960 (57.1) | 616 (58.1) |
| Severe to very severe | 1806 (30.6) | 426 (23.0) | 6305 (27.5) | 4482 (28.4) | 7927 (28.4) | 265 (25.0) |
| Delusions | 190 (3.2) | 87 (4.7) | 848 (3.7) | 575 (3.6) | 1050 (3.8) | 41 (3.9) |
| Verbally or physically abusive behaviour | 810 (13.7) | 270 (14.6) | 3317 (14.5) | 2154 (13.7) | 4119 (14.7) | 157 (14.8) |
| Non-aggressive behavioural problems | 1512 (25.6) | 453 (24.5) | 5908 (25.8) | 4039 (25.6) | 7385 (26.4) | 284 26.8) |
| Cardiovascular morbidity: | ||||||
| Myocardial infarction | 417 (7.1) | 85 (4.6) | 1197 (5.2) | 811 (5.1) | 1587 (5.7) | 48 (4.5) |
| Arrhythmias | 1617 (27.4) | 373 (20.2) | 5262 (23.0) | 3674 (23.3) | 6613 (23.7) | 236 (22.2) |
| Ischaemic heart disease | 297 (5.0) | 74 (4.0) | 1046 (4.6) | 626 (4.0) | 1236 (4.4) | 51 (4.8) |
| Hypertension | 3897 (66.0) | 1262 (68.3) | 14 413 (62.9) | 10 439 (66.2) | 18 129 (64.9) | 748 (70.5) |
| Congestive heart failure | 2286 (38.7) | 562 (30.4) | 7107 (31.0) | 5015 (31.8) | 9057 (32.4) | 362 (34.1) |
| Cerebrovascular disease | 1752 (29.7) | 532 (28.8) | 6445 (28.1) | 4546 (28.8) | 7868 (28.2) | 309 (29.1) |
| Other comorbidities: | ||||||
| Diabetes | 1482 (25.1) | 536 (29.0) | 4699 (20.5) | 3918 (24.8) | 6656 (23.8) | 266 (25.1) |
| Parkinson’s disease | 270 (4.6) | 112 (6.1) | 1132 (4.9) | 1525 (9.7) | 1187 (4.2) | 66 (6.2) |
| Functional impairment: | ||||||
| Independent, supervision, or limited | 2153 (36.5) | 777 (42.0) | 9222 (40.2) | 6055 (38.4) | 11 211 (40.1) | 445 (41.9) |
| Dependence or extensive | 3403 (57.6) | 1012 (54.7) | 12 715 (55.5) | 8982 (56.9) | 15 509 (55.5) | 561 (52.9) |
| Total dependence | 348 (5.9) | 60 (3.2) | 982 (4.3) | 739 (4.7) | 1216 (4.4) | 55 (5.2) |
| General indicators of comorbidity: | ||||||
| Mean Charlson index† | 3.3 | 3.2 | 3.0 | 3.1 | 3.1 | 3.1 |
| Mean No of prescription drugs received | 15.9 | 15.0 | 14.3 | 15.0 | 14.4 | 15.3 |
| Mean No of outpatient visits | 1.1 | 0.8 | 0.9 | 0.9 | 0.9 | 1.1 |
| Mean No of days in hospital | 20.0 | 15.3 | 17.9 | 17.7 | 18.0 | 20.6 |
| History of prescriptions: | ||||||
| Antidepressants | 3617 (61.3) | 1351 (73.1) | 15 863 (69.2) | 11 362 (72.0) | 18 502 (66.2) | 716 (67.5) |
| Hypnotic agents | 3042 (51.5) | 802 (43.4) | 10 493 (45.8) | 7623 (48.3) | 12 570 (45.0) | 485 (45.7) |
| Other psychoactive agents‡ | 656 (11.1) | 283 (15.3) | 3078 (13.4) | 2202 (14.0) | 3335 (11.9) | 149 (14.0) |
| Dementia drug | 1496 (25.3) | 766 (41.4) | 6982 (30.5) | 5742 (36.4) | 9163 (32.8) | 438 (41.3) |
*>50 mg chlorpromazine equivalents, in subset of patients receiving tablets or caplets.
†Individual comorbidities defined based on at least one admission to hospital or at least one outpatient visit with respective ICD codes.
‡Includes barbiturate, non-benzodiazepine anxiolytic, stimulant/ADHD drug, lithium, valproate, carbamazepine, lamotrigine.