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Off-Label Use of Antipsychotics and Health Related Quality of Life in Community Living Older Adults

Author

Listed:
  • Hamzah Bakouni

    (Université de Sherbrooke
    Université de Sherbrooke, Campus Longueuil)

  • Helen-Maria Vasiliadis

    (Université de Sherbrooke
    Université de Sherbrooke, Campus Longueuil)

Abstract

To determine the relationship between off-label use of antipsychotics (AP) and health related quality of life (HRQL) in older adults. This study was based on n = 1020 community living older adults, participating in the ‘Étude sur la santé des ainés’ (ESA)-Services longitudinal study (2010–2015) and covered under Quebec’s public drug insurance plan. Off-label use of AP was identified via the province of Quebec’s health administrative and pharmaceutical databases « Régie d’Assurance Maladie du Québec » (RAMQ). Off-label use was defined by the presence of an AP and the absence, during the same one-year period, of an approved indication by Health Canada. HRQL was measured using a visual analogue scale (HRQL-VAS) and based on functional health status (HRQL-FHS). Multiple linear regressions were used to assess the association between AP use and HRQL at baseline and the change in HRQL at three years follow-up. HRQL-FHS at baseline was positively associated with off-label use of AP compared to on-label use [B = 0.26; 95% CI: 0.12; 0.40]. However, the change in HRQL-FHS was negatively associated with off-label use of AP compared to on-label use [B = −0.18; 95% CI: -0.33; −0.04], and compared to non-use [B = −0.10; 95% CI: -0.18; −0.03]. No association was observed with the HRQL-VAS. Off-label AP users reported better functional health status at baseline, reflecting lower disease severity. The decline in HRQL over the 3-year period in off-label AP use may reflect a lack of AP use efficacy in preventing health status decline.

Suggested Citation

  • Hamzah Bakouni & Helen-Maria Vasiliadis, 2020. "Off-Label Use of Antipsychotics and Health Related Quality of Life in Community Living Older Adults," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 15(4), pages 991-1004, September.
    • Handle: RePEc:spr:ariqol:v:15:y:2020:i:4:d:10.1007_s11482-019-09718-z
    DOI: 10.1007/s11482-019-09718-z
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    References listed on IDEAS

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    1. Glen I Spielmans & Margit I Berman & Eftihia Linardatos & Nicholas Z Rosenlicht & Angela Perry & Alexander C Tsai, 2013. "Adjunctive Atypical Antipsychotic Treatment for Major Depressive Disorder: A Meta-Analysis of Depression, Quality of Life, and Safety Outcomes," PLOS Medicine, Public Library of Science, vol. 10(3), pages 1-24, March.
    2. Amir Shmueli, 1999. "Subjective Health Status and Health Values in the General Population," Medical Decision Making, , vol. 19(2), pages 122-127, April.
    3. Barbara Farrell & Kevin Pottie & Carlos H Rojas-Fernandez & Lise M Bjerre & Wade Thompson & Vivian Welch, 2016. "Methodology for Developing Deprescribing Guidelines: Using Evidence and GRADE to Guide Recommendations for Deprescribing," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-12, August.
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