Factors in second-generation antipsychotic switching patterns in a national sample of older veterans with XXXX .

@entity1 @entity101 @entity28 @entity2299 @entity6 @entity161 @entity209
OBJECTIVE: A 2004 consensus statement by the American Psychiatric Association and other groups noted that metabolic side effects of second-generation antipsychotics require monitoring. To reduce risk, prescribers may consider factors differentially associated with development of @entity209 , such as age, gender, and race-ethnicity. As part of a study of older @entity1 with @entity161 (50-102 years), this study evaluated factors associated with antipsychotic switches and switches that incurred a greater or lesser metabolic risk. METHODS: Administrative data were analyzed for a national cohort of 16,103 Veterans Health Administration @entity1 with @entity161 receiving second-generation antipsychotics. Multinomial logistic regression predicted the likelihood of switches from 2002 to 2003 and again from 2004 to 2005. RESULTS: At baseline nearly half the @entity1 (45%) had a diagnosis of @entity101 , a third (34%) had @entity2299 , and 15% had a diagnosis of @entity28 . In both periods @entity6 was associated with switches to lower-risk antipsychotics, and older @entity1 were likely to experience neutral or no switches. @entity1 were more likely to experience switches to higher-risk antipsychotics in 2004-2005. CONCLUSIONS: General medical conditions potentially associated with antipsychotic-related metabolic concerns were common; however, half of these @entity1 were prescribed medication that made them liable to developing metabolic problems. Modest evidence suggests that metabolic considerations became a higher priority during the study. Future research should investigate the differential impact of antipsychotics on @entity209 for @entity1 and elderly @entity1 . Findings underscore the need to monitor metabolic parameters of older patients taking antipsychotics.
