The following is a summary of “Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic,” published in the January 2023 issue of Psychiatry by Luo, et al.

Antipsychotic medicine may have been used more frequently for dementia patients during the COVID-19 epidemic, which has prompted concerns. For a study, researchers sought to explore global patterns in the prescription of antipsychotic medications for those who were suffering from dementia both before and during the COVID-19 epidemic.

The international network cohort study employed electronic health records. It claimed information from 8 databases in 6 nations (France, Germany, Italy, South Korea, the UK, and the US) for people 65 years or older between January 1, 2016, and November 30, 2021. For South Korea and the US, there were two databases apiece. The key findings were the frequency of dementia patients taking antipsychotic medications in each database and the annual and monthly incidence of dementia diagnosis. In addition, prescription rates were compared before and after implementing population-wide COVID-19 limits using interrupted time series analyses.

In 2016, a total of 857,238 people with dementia aged 65 years or older, of whom 58.0% were female, were identified. During the early phase of the COVID-19 pandemic (April, May, and June 2020), reductions in the incidence of dementia were observed in 7 databases, with the most significant decrease observed in 1 of the 2 US databases (rate ratio [RR], 0.30; 95% CI, 0.27-0.32). In France, Italy, South Korea, the UK, and the US, reductions were also seen in the total number of people with dementia prescribed antipsychotic drugs. However, rates of antipsychotic drug prescribing for people with dementia increased in all countries represented by 6 databases. The most significant increase in antipsychotic drug prescribing in 2020 compared to the corresponding month in 2019 was observed in May in South Korea (Kangwon National University database) (RR, 2.11; 95% CI, 1.47-3.02) and in June in the UK (RR, 1.96; 95% CI, 1.24-3.09). The rates of antipsychotic drug prescribing in these 6 databases remained high in 2021. Interrupted time series analyses revealed immediate increases in the prescribing rate in Italy (RR, 1.31; 95% CI, 1.08-1.58) and in the US Medicare database (RR, 1.43; 95% CI, 1.20-1.71) after the introduction of COVID-19 restrictions.

According to the cohort study, antipsychotic medicine prescription rates for dementia patients increased in the first few months of the COVID-19 pandemic in the six nations examined. However, they did not return to pre-pandemic levels after the acute phase of the pandemic ended. According to these findings, the pandemic interfered with the care of dementia patients, necessitating the creation of intervention measures to guarantee the standard of care.

Reference: jamanetwork.com/journals/jamapsychiatry/fullarticle/2800310