+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Risk of pneumonia in elderly nursing home residents using typical versus atypical antipsychotics

Risk of pneumonia in elderly nursing home residents using typical versus atypical antipsychotics

Annals of PharmacoTherapy 47(4): 464-474

Antipsychotic medications are extensively used in nursing homes for management of behavioral and psychiatric disorders in the elderly. Prior research suggests that pneumonia is one of the common causes of anti psychotic-related mortality in this population. None of the studies compared typical and atypical antipsychotics with respect to pneumonia. To examine the risk of pneumonia with use of typical versus atypical antipsychotics in dual eligible elderly nursing home residents. The study involved a retrospective cohort design matched on propensity score using Medicare and Medicaid Analytical eXtract data from 4 US states. The study population included all elderly dual eligible (Medicaid and Medicare) nursing home residents (aged ≥65 years) who initiated antipsychotics any time between July 1, 2001, and December 31, 2003. The risk of pneumonia during the 6-month follow-up period was modeled using a Cox proportional model and extended Cox hazard model stratified on matched pairs based on propensity score, using atypical agents as the reference category. Analysis of Medicaid-Medicare data revealed that there were 49,904 new antipsychotic (46,293 atypical and 3611 typical) users in the unmatched cohort and 7218 (3609 atypical and 3609 typical) users in the matched cohort. The unadjusted rate of pneumonia was 8.17% (4.61 events per person year) for atypical users and 5.21% (5.21 events per person year) for typical users. HR 1.17, 95% CI 0.83-1.66; and 50-180 days: HR 1.36, 95% CI 0.87-2.14) suggest that there was no significant difference in the risk of pneumonia among typical and atypical users. The study found no differential risk of pneumonia between typical versus atypical antipsychotic use in dual eligible nursing home residents. Given the differential risk of mortality with typical and atypical antipsychotic use in nursing homes, more research is needed to evaluate other contributory factors of mortality with respect to these 2 antipsychotic classes.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 036845065

Download citation: RISBibTeXText

PMID: 23548651

DOI: 10.1345/aph.1R510

Related references

Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents. Psychiatric Services 65(6): 781-788, 2015

Risk of death in dual-eligible nursing home residents using typical or atypical antipsychotic agents. Medical Care 50(11): 961-969, 2013

Atypical antipsychotics and the risk of diabetes in an elderly population in long-term care: a retrospective nursing home chart review study. Journal of the American Medical Directors Association 10(2): 115-119, 2009

Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi Method. Bmc Geriatrics 16: 60, 2016

Do atypical antipsychotics cause weight gain in nursing home dementia residents?. Consultant Pharmacist 19(9): 809-812, 2006

All-cause mortality associated with atypical and conventional antipsychotics among nursing home residents with dementia: a retrospective cohort study. Journal of Clinical Psychiatry 70(10): 1340-1347, 2009

Use of antipsychotics among elderly nursing home residents with dementia in the US: an analysis of National Survey Data. Drugs and Aging 26(6): 483-492, 2009

Comparative safety of atypical antipsychotics and the risk of pneumonia in the elderly. Pharmacoepidemiology and Drug Safety 24(12): 1271-1280, 2016

Management of the agitated elderly patient in the nursing home: the role of the atypical antipsychotics. Journal of Clinical Psychiatry 59 Suppl 19: 50-55, 1998

Incidence of tardive dyskinesia with typical versus atypical antipsychotics in very high risk patients. Neurology 60(5 Supplement 1): A126, March 11, 2003

Cerebrovascular events among elderly nursing home patients treated with conventional or atypical antipsychotics. Journal of Clinical Psychiatry 66(9): 1090-1096, 2005

Presentation of pneumonia in elderly nursing home residents. Journal of the American Geriatrics Society 47(9): S74, Sept, 1999

Depot Typical Antipsychotics versus Oral Atypical Antipsychotics in Relapse Rate Among Patients with Schizophrenia: A Five -Year Historical Cohort Study. Iranian Journal of Psychiatry and Behavioral Sciences 8(1): 66-71, 2014

Risk factors for pneumonia in nursing home residents. Journal of the American Geriatrics Society 43(12): 1443-1444, 1995

Relationship between oral bacteria count and pneumonia onset in elderly nursing home residents. Geriatrics and Gerontology International 15(4): 417-421, 2016