Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals
Abstract Background Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer’s disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia...
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12911-022-01892-9 |
| _version_ | 1811194880696778752 |
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| author | Alok Joshi Stephen Todd David P. Finn Paula L. McClean KongFatt Wong-Lin |
| author_facet | Alok Joshi Stephen Todd David P. Finn Paula L. McClean KongFatt Wong-Lin |
| author_sort | Alok Joshi |
| collection | DOAJ |
| description | Abstract Background Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer’s disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia. Available medications provide symptomatic benefits and provide relief from BPSD and associated health issues. However, it is unclear how specific dementia, antidepressant, antipsychotic, antianxiety, and mood stabiliser drugs, used in the treatment of depression and dementia subtypes are prescribed in hospital admission, during hospital stay, and at the time of discharge. To address this, we apply multi-dimensional data analytical approaches to understand drug prescribing practices within hospitals in England and Wales. Methods We made use of the UK National Audit of Dementia (NAD) dataset and pre-processed the dataset. We evaluated the pairwise Pearson correlation of the dataset and selected key data features which are highly correlated with dementia subtypes. After that, we selected drug prescribing behaviours (e.g. specific medications at the time of admission, during the hospital stay, and upon discharge), drugs and disorders. Then to shed light on the relations across multiple features or dimensions, we carried out multiple regression analyses, considering the number of dementia, antidepressant, antipsychotic, antianxiety, mood stabiliser, and antiepileptic/anticonvulsant drug prescriptions as dependent variables, and the prescription of other drugs, number of patients with dementia subtypes (AD/VaD), and depression as independent variables. Results In terms of antidepressant drugs prescribed in hospital admission, during stay and discharge, the number of sertraline and venlafaxine prescriptions were associated with the number of VaD patients whilst the number of mirtazapine prescriptions was associated with frontotemporal dementia patients. During admission, the number of lamotrigine prescriptions was associated with frontotemporal dementia patients, and with the number of valproate and dosulepin prescriptions. During discharge, the number of mirtazapine prescriptions was associated with the number of donepezil prescriptions in conjunction with frontotemporal dementia patients. Finally, the number of prescriptions of donepezil/memantine at admission, during hospital stay and at discharge exhibited positive association with AD patients. Conclusion Our analyses reveal a complex, multifaceted set of interactions among prescribed drug types, dementia subtypes, and depression. |
| first_indexed | 2024-04-12T00:33:42Z |
| format | Article |
| id | doaj.art-f686719faeba439d86f60b6a08e63e90 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-04-12T00:33:42Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-f686719faeba439d86f60b6a08e63e902022-12-22T03:55:15ZengBMCBMC Medical Informatics and Decision Making1472-69472022-10-0122111110.1186/s12911-022-01892-9Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitalsAlok Joshi0Stephen Todd1David P. Finn2Paula L. McClean3KongFatt Wong-Lin4Intelligent Systems Research Centre, Ulster University, Magee CampusAltnagelvin Area Hospital, Western Health and Social Care TrustPharmacology and Therapeutics, School of Medicine, Galway Neuroscience Centre, National University of Ireland GalwayNorthern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, Ulster UniversityIntelligent Systems Research Centre, Ulster University, Magee CampusAbstract Background Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer’s disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia. Available medications provide symptomatic benefits and provide relief from BPSD and associated health issues. However, it is unclear how specific dementia, antidepressant, antipsychotic, antianxiety, and mood stabiliser drugs, used in the treatment of depression and dementia subtypes are prescribed in hospital admission, during hospital stay, and at the time of discharge. To address this, we apply multi-dimensional data analytical approaches to understand drug prescribing practices within hospitals in England and Wales. Methods We made use of the UK National Audit of Dementia (NAD) dataset and pre-processed the dataset. We evaluated the pairwise Pearson correlation of the dataset and selected key data features which are highly correlated with dementia subtypes. After that, we selected drug prescribing behaviours (e.g. specific medications at the time of admission, during the hospital stay, and upon discharge), drugs and disorders. Then to shed light on the relations across multiple features or dimensions, we carried out multiple regression analyses, considering the number of dementia, antidepressant, antipsychotic, antianxiety, mood stabiliser, and antiepileptic/anticonvulsant drug prescriptions as dependent variables, and the prescription of other drugs, number of patients with dementia subtypes (AD/VaD), and depression as independent variables. Results In terms of antidepressant drugs prescribed in hospital admission, during stay and discharge, the number of sertraline and venlafaxine prescriptions were associated with the number of VaD patients whilst the number of mirtazapine prescriptions was associated with frontotemporal dementia patients. During admission, the number of lamotrigine prescriptions was associated with frontotemporal dementia patients, and with the number of valproate and dosulepin prescriptions. During discharge, the number of mirtazapine prescriptions was associated with the number of donepezil prescriptions in conjunction with frontotemporal dementia patients. Finally, the number of prescriptions of donepezil/memantine at admission, during hospital stay and at discharge exhibited positive association with AD patients. Conclusion Our analyses reveal a complex, multifaceted set of interactions among prescribed drug types, dementia subtypes, and depression.https://doi.org/10.1186/s12911-022-01892-9DementiaAlzheimer’s diseaseVascular dementiaDepressionAntidepressantAntipsychotic |
| spellingShingle | Alok Joshi Stephen Todd David P. Finn Paula L. McClean KongFatt Wong-Lin Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals BMC Medical Informatics and Decision Making Dementia Alzheimer’s disease Vascular dementia Depression Antidepressant Antipsychotic |
| title | Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals |
| title_full | Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals |
| title_fullStr | Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals |
| title_full_unstemmed | Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals |
| title_short | Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals |
| title_sort | multi dimensional relationships among dementia depression and prescribed drugs in england and wales hospitals |
| topic | Dementia Alzheimer’s disease Vascular dementia Depression Antidepressant Antipsychotic |
| url | https://doi.org/10.1186/s12911-022-01892-9 |
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