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Katia M C Verhamme

Publications and source records attributed to Katia M C Verhamme.

4 recordsLinked to original sources

All-cause mortality associated with atypical and typical antipsychotics in demented outpatients.

PURPOSE: To estimate the association between use of typical and atypical antipsychotics and all-cause mortality in a population of demented outpatients. METHODS: The study cohort comprised all demented patients older than 65 years and registered in the Integrated Primary Care Information (IPCI) database, during 1996-2004. First, mortality rates were calculated during use of atypical and typical antipsychotics. Second, we assessed the association between use of atypical and typical antipsychotics and all-cause mortality through a nested case-control study in the cohort of demented patients. Each case was matched to all eligible controls at the date of death by age and duration of dementia. Odds ratios were estimated through conditional logistic regression analyses. RESULTS: The crude mortality rate was 30.1 (95%CI: 18.2-47.1) and 25.2 (21.0-29.8) per 100 person-years (PY) during use of atypical and typical antipsychotics, respectively. No significant difference in risk of death was observed between current users of atypical and typical antipsychotics (OR = 1.3; 95%CI: 0.7-2.4). Both types of antipsychotics were associated with a significantly increased risk of death as compared to non-users (OR = 2.2, 1.2-3.9 for atypical antipsychotics; OR=1.7, 1.3-2.2 for typical antipsychotics). CONCLUSIONS: Conventional antipsychotic drug should be included in the FDA's Public Health advisory, which currently warns only of the increased risk of death with the use of atypical antipsychotics in elderly demented persons.

Age Factors↗

Nonsteroidal anti-inflammatory drugs and increased risk of acute urinary retention.

BACKGROUND: Acute urinary retention (AUR) is characterized by the sudden inability to urinate, which is usually extremely painful and requires catheterization. Prostaglandins play an important role in the genitourinary function as they provoke contractions of the detrusor muscle. Relaxation of the detrusor muscle, via the inhibition of the prostaglandin synthesis, could result in AUR. METHODS: We conducted a population-based case-control study within the Integrated Primary Care Information project in the Netherlands to investigate whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of AUR. All men 45 years or older registered in the database between 1995 and 2002 and with at least 6 months of valid history were included. Cases were all men with a validated diagnosis of AUR. To each case, up to 10 controls were matched on age and calendar time. RESULTS: Within the source population of 72 114 men, we identified 536 cases of AUR and 5348 matched controls. Risk of AUR was 2.02-fold higher in current users of NSAIDs than in nonusers (95% confidence interval, 1.23-3.31). The highest risk for AUR (adjusted odds ratio, 3.3; 95% confidence interval, 1.2-9.2) was observed in patients who recently started using NSAIDs and in those using a dose equal to or higher than the recommended daily dose. CONCLUSION: This study shows that the risk of AUR is about 2-fold higher in men who use NSAIDs.

Acute Disease↗

Inappropriate drug prescribing in older adults: the updated 2002 Beers criteria--a population-based cohort study.

BACKGROUND: In 1997, Beers and colleagues developed explicit criteria for potentially inappropriate drug prescribing in ambulatory older adults aged 65 years and over. Several studies have been performed to estimate the prevalence of inappropriate drug prescribing based on these criteria. In 2002, the criteria were updated. AIMS: To examine the extent and trend of inappropriate drug prescribing to ambulatory older adults in the Netherlands between 1997 and 2001, according to the 1997 and the updated Beers criteria. METHODS: Data were retrieved from the Integrated Primary Care Information (IPCI) project, a general practice research database with data from computer-based patient records of a group of 150 general practitioners in the Netherlands. All subjects aged 65 and over were included. Prescriptions were classified as inappropriate if they fulfilled the Beers criteria of prescriptions that generally should be avoided in older adults because of a high risk of adverse effects, while also considering dose and comorbidity. RESULTS: Between 1997 and 2001, the 1-year risk of receiving at least one inappropriate drug prescription for older adults ranged between 16.8% (95% CI: 16.3-17.3%) and 18.5% (18.3-18.7%) according to the 1997 criteria and between 19.1% (18.6-19.6%) and 20.0% (19.5-20.5%) according to the updated Beers criteria. According to the updated criteria, the most frequently prescribed inappropriate drugs were nitrofurantoin, long-acting benzodiazepines, amitriptyline, promethazine and cimetidine. Temazepam and zolpidem were mostly prescribed in supratherapeutic dose. Conventional NSAIDs in persons with a history of gastric/duodenal ulcer were the most frequently prescribed contra-indicated drugs. CONCLUSIONS: Prescribing potentially inappropriate prescriptions to ambulatory older people in the Netherlands is substantial. Compared with other studies using the 1997 Beers criteria, inappropriate prescribing to the elderly is lower than in the USA but similar to Finland. Despite a restrictive medication policy and a growing attention for medication surveillance in Europe, inappropriate drug prescribing is still a substantial problem.

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