Paweł Zagozdzon , Piotr Dorozynski , Przemysław Waszak , Adam Harasimowicz , Tomasz Dziubich
{"title":"抗精神病药物处方序列分析与死亡发生和心脏代谢药物使用的关系：一项回顾性纵向研究","authors":"Paweł Zagozdzon , Piotr Dorozynski , Przemysław Waszak , Adam Harasimowicz , Tomasz Dziubich","doi":"10.1016/j.ejpsy.2022.06.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><p>The potential role of antipsychotics<span> in increasing cardiovascular risk of mortality is still debated. The aim of this study was to assess the death risk associated with sequences of first-generation antipsychotic (FGA) and second-generation antipsychotic (SGA) prescriptions, including clozapine<span> and lithium, and drugs<span> for cardiometabolic diseases.</span></span></span></p></div><div><h3>Methods</h3><p>We conducted a retrospective longitudinal analysis involving 84,881 patients who received antipsychotics between 2008 and 2012. Data on deaths were collected from the National Death Registry. The sequence creation was performed according to an algorithm that iterates prescriptions in chronological order and appends them to the end of the patient's prescription sequence. Fuzzy set qualitative comparative analysis (FsQCA) was also used to produce causal combinations of conditions that best lead to survival.</p></div><div><h3>Results</h3><p>There were 1,095,518 antipsychotic prescriptions and 16,010 deaths among antipsychotic users. Among the reimbursement data, 85,272 drug sequences were identified. The most prevalent sequence consisted of FGA (69.1%). Subsequent groups consisted of FGA, followed by SGA (13.1%) and SGA-only (12.3%) sequences. The highest occurrence of death and cardiometabolic drug use after introducing antipsychotic treatment was observed for clozapine. The FsQCA analysis revealed the highest coverage for combinations of young age with FGA (40.6%) or with no cardiometabolic risk factors drug therapy (39.5%).</p></div><div><h3>Conclusion</h3><p>The sequence analysis suggests that clozapine is associated with an increased death risk compared to FGA and SGA.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"37 1","pages":"Pages 1-7"},"PeriodicalIF":2.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Antipsychotic drug prescription sequence analysis in relation to death occurrence and cardiometabolic drug usage: A retrospective longitudinal study\",\"authors\":\"Paweł Zagozdzon , Piotr Dorozynski , Przemysław Waszak , Adam Harasimowicz , Tomasz Dziubich\",\"doi\":\"10.1016/j.ejpsy.2022.06.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><p>The potential role of antipsychotics<span> in increasing cardiovascular risk of mortality is still debated. The aim of this study was to assess the death risk associated with sequences of first-generation antipsychotic (FGA) and second-generation antipsychotic (SGA) prescriptions, including clozapine<span> and lithium, and drugs<span> for cardiometabolic diseases.</span></span></span></p></div><div><h3>Methods</h3><p>We conducted a retrospective longitudinal analysis involving 84,881 patients who received antipsychotics between 2008 and 2012. Data on deaths were collected from the National Death Registry. The sequence creation was performed according to an algorithm that iterates prescriptions in chronological order and appends them to the end of the patient's prescription sequence. Fuzzy set qualitative comparative analysis (FsQCA) was also used to produce causal combinations of conditions that best lead to survival.</p></div><div><h3>Results</h3><p>There were 1,095,518 antipsychotic prescriptions and 16,010 deaths among antipsychotic users. Among the reimbursement data, 85,272 drug sequences were identified. The most prevalent sequence consisted of FGA (69.1%). Subsequent groups consisted of FGA, followed by SGA (13.1%) and SGA-only (12.3%) sequences. The highest occurrence of death and cardiometabolic drug use after introducing antipsychotic treatment was observed for clozapine. The FsQCA analysis revealed the highest coverage for combinations of young age with FGA (40.6%) or with no cardiometabolic risk factors drug therapy (39.5%).</p></div><div><h3>Conclusion</h3><p>The sequence analysis suggests that clozapine is associated with an increased death risk compared to FGA and SGA.</p></div>\",\"PeriodicalId\":12045,\"journal\":{\"name\":\"European Journal of Psychiatry\",\"volume\":\"37 1\",\"pages\":\"Pages 1-7\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0213616322000532\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0213616322000532","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Antipsychotic drug prescription sequence analysis in relation to death occurrence and cardiometabolic drug usage: A retrospective longitudinal study
Background and objectives
The potential role of antipsychotics in increasing cardiovascular risk of mortality is still debated. The aim of this study was to assess the death risk associated with sequences of first-generation antipsychotic (FGA) and second-generation antipsychotic (SGA) prescriptions, including clozapine and lithium, and drugs for cardiometabolic diseases.
Methods
We conducted a retrospective longitudinal analysis involving 84,881 patients who received antipsychotics between 2008 and 2012. Data on deaths were collected from the National Death Registry. The sequence creation was performed according to an algorithm that iterates prescriptions in chronological order and appends them to the end of the patient's prescription sequence. Fuzzy set qualitative comparative analysis (FsQCA) was also used to produce causal combinations of conditions that best lead to survival.
Results
There were 1,095,518 antipsychotic prescriptions and 16,010 deaths among antipsychotic users. Among the reimbursement data, 85,272 drug sequences were identified. The most prevalent sequence consisted of FGA (69.1%). Subsequent groups consisted of FGA, followed by SGA (13.1%) and SGA-only (12.3%) sequences. The highest occurrence of death and cardiometabolic drug use after introducing antipsychotic treatment was observed for clozapine. The FsQCA analysis revealed the highest coverage for combinations of young age with FGA (40.6%) or with no cardiometabolic risk factors drug therapy (39.5%).
Conclusion
The sequence analysis suggests that clozapine is associated with an increased death risk compared to FGA and SGA.
期刊介绍：
The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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