The Explanatory Role of Stroke as a Mediator of the Mortality Risk Difference Between Older Adults Who Initiate First- Versus Second-Generation Antipsychotic Drugs
Why the study?
Does stroke mediate the difference in mortality risk between first-generation and second-generation antipsychotic drugs in older adults?
Population
30,941 older adults who initiated use of antipsychotic drugs, enrolled in Medicare and either the New Jersey…
Comparison
First-generation antipsychotic drugs (FGAs) vs Second-generation antipsychotic drugs (SGAs)
Design
Cohort
Follow-up
180 days
Authors
Discussion
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Member takes
Implication
Stroke mediates little of the FGA mortality excess in older adults; leaves open non-stroke pathways for investigation.
Structured PICO
Does stroke mediate the difference in mortality risk between first-generation and second-generation antipsychotic drugs in older adults?
P
Population
30,941 older adults (aged ≥65 years) who initiated use of antipsychotic drugs (9,777 FGA users and 21,164 SGA users), enrolled in Medicare and either the New Jersey or Pennsylvania pharmacy assistance program during 1994 to 2005.
I
Intervention
First-generation antipsychotic drugs (FGAs)
C
Comparator
Second-generation antipsychotic drugs (SGAs)
O
Outcome
Stroke and death at 180 days, specifically assessing stroke as a mediator of mortality riskhard clinical
The higher mortality risk associated with first-generation compared to second-generation antipsychotics in older adults is largely not mediated by an increased risk of stroke.
Cite This Study
Jackson et al. (2014) studied this question.