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dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.contributor.authorSoto Ruiz de Gordoa, Myriam
dc.contributor.otherMar, Javier
dc.contributor.otherArrospide, Arantzazu
dc.contributor.otherIruin, Álvaro
dc.contributor.otherTainta, Mikel
dc.contributor.otherGabilondo, Andrea
dc.contributor.otherMar-Barrutia, Lore
dc.contributor.otherCalvo, Montserrat
dc.contributor.otherIbarrondo, Oliver
dc.identifier.issn1178-2021 onlineen
dc.identifier.issn1176-6328 printen
dc.description.abstractBackground: Dementia-related neuropsychiatric symptoms (NPS) are the main determinant of family stress and institutionalization of patients. This study aimed to identify inequalities by gender and socioeconomic status in the management of NPS in patients diagnosed with dementia. Methods: An observational study was carried out to study all the cases of dementia in the corporate database of the Basque Health Service (29,864 patients). The prescription of antipsychotics and antidepressants and admission to a nursing home were used to establish the presence of NPS. The socioeconomic status of individuals was classified by a deprivation index. Logistic regressions were used to identify drivers for drug prescriptions and institutionalization. Results: NPS are poorly recorded in the clinical databases (12%). Neuropsychiatric symptoms were severe enough in two thirds of patients with dementia to be treated with psychoactive medication. Institutionalization showed an increase from those who did not receive medication to those who had been prescribed antidepressants (OR: 1.546), antipsychotics (OR: 2.075) or both (OR: 2.741). The resulting inequalities were the increased prescription of antidepressant drugs in women and more nursing-home admissions for women who were the least socioeconomically deprived and men who were the most deprived. Conclusions: In large clinical databases, psychoactive drugs prescriptions can be useful to underscore the considerable burden of dementia-related NPS. Specific tools are needed to monitor social and health care programs targeted to dementia-related NPS from a population perspective. Programs aimed at reducing the family burden of care of dementia patients at home become the key elements in reducing inequalities in these patients’ care. Socioeconomic status is the most important driver of inequality, and gender inequality may simply be hidden within the social environment. Integrated programs boosting the continuity of care are an objective for which compliance could be measured according to the NPS coding in the electronic health record.en
dc.description.sponsorshipGobierno Vascoes
dc.publisherDove Medical Press Limiteden
dc.rights© Dove Medical Press Limiteden
dc.subjectneuropsychiatric symptomsen
dc.subjectantidepressant drugsen
dc.subjectantipsychotic drugsen
dc.subjectnursing homeen
dc.subjectdeprivation indexen
dc.titleDementia related neuropsychiatric symptoms: inequalities in pharmacological treatment and institutionalizationen
dcterms.sourceNeuropsychiatric disease and treatment. Vol 15. Pp. 2027-2034. November, 2019en
local.contributor.groupInnovación, gestión, organizaciónes
local.relation.projectIDBIOEF BIO12/AL/005en
local.relation.projectIDBIOEF BIOD17/ND/015en
local.rights.publicationfeeamount2270 EURen
local.contributor.otherinstitutionOsakidetza. Organización Sanitaria Integrada Debagoienaes
local.contributor.otherinstitutionOsakidetza. Instituto de Investigación Sanitaria Biodonostiaes
local.contributor.otherinstitutionCentro de Investigación y Terapias Avanzadas para la enfermedad de Alzheimer (Fundación CITA Alzheimer)es
local.contributor.otherinstitutionOsakidetza. Organización Sanitaria Integrada Goierri-Urola Garaiaes
local.contributor.otherinstitutionHospital Universitari de Bellvitgees
local.contributor.otherinstitutionGobierno Vasco. Departamento de Saludes
local.contributor.otherinstitutionOsakidetza. Red de Salud Mental de Gipuzkoaes

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