Mediators of First- Versus Second-generation Antipsychotic-related Mortality in Older Adults
Why the study?
Do first-generation antipsychotics increase mortality compared to second-generation antipsychotics in older adults?
Population
26,197 older adults enrolled in New Jersey and Pennsylvania Medicare
Comparison
First-generation antipsychotics vs Second-generation antipsychotics
Design
Cohort
Follow-up
180 days
Authors
Discussion
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Implication
Higher mortality with first-generation antipsychotics may be mediated by cardiovascular, infectious, and fracture events; leaves open residual confounding.
Structured PICO
Do first-generation antipsychotics increase mortality compared to second-generation antipsychotics in older adults?
P
Population
26,197 older adults enrolled in New Jersey and Pennsylvania Medicare (n=9,060 initiators of first-generation antipsychotics and n=17,137 initiators of second-generation antipsychotics)
I
Intervention
First-generation antipsychotics
C
Comparator
Second-generation antipsychotics
O
Outcome
Mortality at 180 dayshard clinical
Acute cardiovascular events and pneumonia partially mediate the higher mortality risk associated with first-generation compared to second-generation antipsychotics in older adults.
Limitations
- False-negative mediator misclassification in claims data
Cite This Study
Jackson et al. (2015) studied this question.