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Bourcier E, Korb-Savoldelli V, Hejblum G, Fernandez C, Hindlet P. A systematic review of regulatory and educational interventions to reduce the burden associated with the prescriptions of sedative-hypnotics in adults treated for sleep disorders. PLoS One 2018; 13:e0191211. [PMID: 29357377 PMCID: PMC5777652 DOI: 10.1371/journal.pone.0191211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/29/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The burden of Sedative-Hypnotics (SHs) has been known since the 1980s. Yet, their consumption remains high. A systematic review of the literature should help to assess efficient interventions to improve the appropriate use of SHs in sleep disorders. OBJECTIVES To identify and assess regulatory and educational interventions designed to improve the appropriate use of SHs for insomnia treatment. METHODS We conducted a systematic review of the literature according to PRISMA guidelines. A systematic search covering the period 1980-2015 was carried out in Medline, Web of Science, Embase and PsycInfo. We included studies reporting the implementation of regulatory or educational strategies directed towards patients and/or healthcare professionals to improve the appropriate use of SHs to treat insomnia in the community, hospitals and nursing homes. RESULTS Thirty-one studies were included: 23 assessed educational interventions (recommendations by mail/email, computer alerts, meetings, mass media campaigns, prescription profile), 8 assessed regulatory interventions (prescription rule restriction, end of reimbursement). The most recent was implemented in 2009. Restrictive prescription rules were effective to reduce the consumption of targeted SHs but led to a switch to other non-recommended SHs. Among educational interventions, only 3 studies out of 7 reported positive results of mono-faceted interventions; whereas, 13 out of the 16 multi-faceted interventions were reported as efficient: particularly, the active involvement of healthcare professionals and patients and the spread of information through mass media were successful. The risk of bias was high for 24 studies (mainly due to the design), moderate for 3 studies and weak for 4 studies. CONCLUSION Educational multifaceted studies are presented as the most efficient. But further better designed studies are needed to make evidence-based results more generalizable.
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Affiliation(s)
- Elsa Bourcier
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136, Paris, France
- Service de pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France
- Faculté de pharmacie, Université Paris-Sud, Châtenay-Malabry, France
| | - Virginie Korb-Savoldelli
- Faculté de pharmacie, Université Paris-Sud, Châtenay-Malabry, France
- Service de pharmacie, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Gilles Hejblum
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136, Paris, France
| | - Christine Fernandez
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136, Paris, France
- Service de pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France
- Faculté de pharmacie, Université Paris-Sud, Châtenay-Malabry, France
| | - Patrick Hindlet
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136, Paris, France
- Service de pharmacie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France
- Faculté de pharmacie, Université Paris-Sud, Châtenay-Malabry, France
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55
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Chan TT, Leung WCY, Li V, Wong KYW, Chu WM, Leung KC, Ng YZ, Kai YMG, Shea YF, Chang SKR, Chu LW. Association between high cumulative dose of benzodiazepine in Chinese patients and risk of dementia: a preliminary retrospective case-control study. Psychogeriatrics 2017; 17:310-316. [PMID: 28145025 DOI: 10.1111/psyg.12239] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/07/2016] [Accepted: 11/21/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence describing the association between high-dose benzodiazepine use and dementia has been conflicting. Most previous studies involved Caucasian populations, with only limited data on Chinese subjects. Possible differences exist between Chinese and Caucasian populations with regard to metabolism and prescription practice. This study aimed to assess the association between high-dose benzodiazepine use and dementia in a Chinese population. METHOD A retrospective case-control study was carried out in all public hospitals under the Hong Kong Hospital Authority Hong Kong West Cluster between 2000 and 2015. The study recruited 273 Chinese adults (91 cases, 182 controls) aged 75 and over, with at least 6 years of follow-up data. Each dementia case was matched with two controls according to sex, age group, and duration of follow-up. The number of patients with benzodiazepine ever-use and the exposure density based on the prescribed daily doses were assessed. Prescribed daily doses were categorized as either <1096 or ≥1096. Odds ratios and 95% confidence intervals were computed by multivariate analysis. RESULTS The difference in exposure density between the dementia and control groups was statistically significant between prescribed daily doses <1096 and ≥1096 (P = 0.02). There were two multivariate analyses models; one factored in depression (model 1), and the other (model 2) did not. Model 2 showed a statistically significant association (odds ratio = 1.71, 95% confidence intervals = 1.02-2.89, P = 0.04) between benzodiazepine exposure density and dementia. CONCLUSION High-dose benzodiazepine use may be associated with dementia in the Chinese population. Prospective studies are required.
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Affiliation(s)
- Tsz-Tai Chan
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - William Chun-Yin Leung
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Victor Li
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Kin-Yiu Wesley Wong
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Wing-Ming Chu
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Ka-Chun Leung
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Yuey-Zhun Ng
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Yuen-Ming Gary Kai
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.,Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Yat-Fung Shea
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong
| | | | - Leung-Wing Chu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.,Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong
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56
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Jun GR, Chung J, Mez J, Barber R, Beecham GW, Bennett DA, Buxbaum JD, Byrd GS, Carrasquillo MM, Crane PK, Cruchaga C, De Jager P, Ertekin-Taner N, Evans D, Fallin MD, Foroud TM, Friedland RP, Goate AM, Graff-Radford NR, Hendrie H, Hall KS, Hamilton-Nelson KL, Inzelberg R, Kamboh MI, Kauwe JSK, Kukull WA, Kunkle BW, Kuwano R, Larson EB, Logue MW, Manly JJ, Martin ER, Montine TJ, Mukherjee S, Naj A, Reiman EM, Reitz C, Sherva R, St George-Hyslop PH, Thornton T, Younkin SG, Vardarajan BN, Wang LS, Wendlund JR, Winslow AR, Haines J, Mayeux R, Pericak-Vance MA, Schellenberg G, Lunetta KL, Farrer LA. Transethnic genome-wide scan identifies novel Alzheimer's disease loci. Alzheimers Dement 2017; 13:727-738. [PMID: 28183528 PMCID: PMC5496797 DOI: 10.1016/j.jalz.2016.12.012] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/28/2016] [Accepted: 12/28/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Genetic loci for Alzheimer's disease (AD) have been identified in whites of European ancestry, but the genetic architecture of AD among other populations is less understood. METHODS We conducted a transethnic genome-wide association study (GWAS) for late-onset AD in Stage 1 sample including whites of European Ancestry, African-Americans, Japanese, and Israeli-Arabs assembled by the Alzheimer's Disease Genetics Consortium. Suggestive results from Stage 1 from novel loci were followed up using summarized results in the International Genomics Alzheimer's Project GWAS dataset. RESULTS Genome-wide significant (GWS) associations in single-nucleotide polymorphism (SNP)-based tests (P < 5 × 10-8) were identified for SNPs in PFDN1/HBEGF, USP6NL/ECHDC3, and BZRAP1-AS1 and for the interaction of the (apolipoprotein E) APOE ε4 allele with NFIC SNP. We also obtained GWS evidence (P < 2.7 × 10-6) for gene-based association in the total sample with a novel locus, TPBG (P = 1.8 × 10-6). DISCUSSION Our findings highlight the value of transethnic studies for identifying novel AD susceptibility loci.
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Affiliation(s)
- Gyungah R Jun
- Neurogenetics and Integrated Genomics, Andover Innovative Medicines Institute, Eisai Inc, Andover, MA, USA; Department of Medicine (Biomedical Genetics), Boston University Schools of Medicine, Boston, MA, USA
| | - Jaeyoon Chung
- Department of Medicine (Biomedical Genetics), Boston University Schools of Medicine, Boston, MA, USA
| | - Jesse Mez
- Department of Neurology, Boston University Schools of Medicine, Boston, MA, USA
| | - Robert Barber
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Gary W Beecham
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - David A Bennett
- Department of Neurological Sciences and Rush Alzheimer's Disease Center, Chicago, IL, USA
| | - Joseph D Buxbaum
- Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA; Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA; Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY, USA
| | - Goldie S Byrd
- Department of Biology, North Carolina A&T State University, Greensboro, NC, USA
| | | | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Carlos Cruchaga
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Philip De Jager
- Program in Translational NeuroPsychiatric Genomics, Institute for the Neurosciences, Department of Neurology & Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | | | - Denis Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - M Danielle Fallin
- Department of Mental Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tatiana M Foroud
- Department of Medical & Molecular Genetics, Indiana University, Indianapolis, IN, USA
| | | | - Alison M Goate
- Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA
| | | | - Hugh Hendrie
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA; Regenstrief Institute, Inc, Indianapolis, IN, USA
| | - Kathleen S Hall
- Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Medicine, Indiana University, Indianapolis, IN, USA
| | | | - Rivka Inzelberg
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - M Ilyas Kamboh
- University of Pittsburgh Alzheimer's Disease Research Center and Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, WA, USA; National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, USA
| | - Brian W Kunkle
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Ryozo Kuwano
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Eric B Larson
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA; Group Health, Group Health Research Institute, Seattle, WA, USA
| | - Mark W Logue
- Department of Medicine (Biomedical Genetics), Boston University Schools of Medicine, Boston, MA, USA; Department of Neurological Sciences and Rush Alzheimer's Disease Center, Chicago, IL, USA; National Center for PTSD, Behavioral Science Division, Boston VA Healthcare System, Boston, MA, USA
| | - Jennifer J Manly
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Eden R Martin
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | | | | | - Adam Naj
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Eric M Reiman
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Department of Psychiatry, University of Arizona, Phoenix, AZ, USA; Banner Alzheimer's Institute, Phoenix, AZ, USA; Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Christiane Reitz
- The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Epidemiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University Schools of Medicine, Boston, MA, USA
| | - Peter H St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Canada; Cambridge Institute for Medical Research and Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Timothy Thornton
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Badri N Vardarajan
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Li-San Wang
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Jens R Wendlund
- PharmaTherapeutics Clinical Research, Pfizer Worldwide Research and Development, Cambridge, MA, USA
| | - Ashley R Winslow
- PharmaTherapeutics Clinical Research, Pfizer Worldwide Research and Development, Cambridge, MA, USA
| | - Jonathan Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Mayeux
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; The Department of Epidemiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | | | - Kathryn L Lunetta
- Department of Biostatistics, Boston University Schools of Public Health, Boston, MA, USA
| | - Lindsay A Farrer
- Department of Medicine (Biomedical Genetics), Boston University Schools of Medicine, Boston, MA, USA; Department of Neurology, Boston University Schools of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University Schools of Public Health, Boston, MA, USA; Department of Ophthalmology, Boston University Schools of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University Schools of Public Health, Boston, MA, USA.
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58
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Gros A, Bensamoun D, Manera V, Fabre R, Zacconi-Cauvin AM, Thummler S, Benoit M, Robert P, David R. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders. Front Aging Neurosci 2016; 8:269. [PMID: 27877126 PMCID: PMC5099137 DOI: 10.3389/fnagi.2016.00269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/24/2016] [Indexed: 12/27/2022] Open
Abstract
Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia.
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Affiliation(s)
- Auriane Gros
- Département de Neurologie, Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de DijonDijon, France; CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
| | - David Bensamoun
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Département de Psychiatrie, Hôpital Pasteur, Centre Hospitalier Universitaire de NiceNice, France
| | - Valeria Manera
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia Antipolis Nice, France
| | - Roxane Fabre
- Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France; Département de Santé Publique, Hôpital L'Archet, Centre Hospitalier Universitaire de NiceNice, France
| | | | - Susanne Thummler
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia Antipolis Nice, France
| | - Michel Benoit
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Département de Psychiatrie, Hôpital Pasteur, Centre Hospitalier Universitaire de NiceNice, France
| | - Philippe Robert
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
| | - Renaud David
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
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