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

Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer’s disease in 2005-2011.
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Tolppanen AM, Voutilainen A, Taipale H, Tanskanen A, Lavikainen P, Koponen M, Tiihonen J, Hartikainen S,


Tolppanen AM, Voutilainen A, Taipale H, Tanskanen A, Lavikainen P, Koponen M, Tiihonen J, Hartikainen S, (click to view)

Tolppanen AM, Voutilainen A, Taipale H, Tanskanen A, Lavikainen P, Koponen M, Tiihonen J, Hartikainen S,

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PloS one 2017 03 0912(3) e0173450 doi 10.1371/journal.pone.0173450
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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