Sex-Specific Associations Between Bipolar Disorder Pharmacological Maintenance Therapies and Inpatient Rehospitalizations : A 9-Year Swedish National Registry Study
(2020) In Frontiers in Psychiatry 11.- Abstract
Background: Long-term pharmacological maintenance therapy is often essential among people with bipolar disorder to reduce the need for inpatient care. Sex-specific responses to maintenance therapies are expected but remain largely unknown. Here, we examined for sex-specific associations between common maintenance therapies for bipolar disorder with inpatient rehospitalizations following patients' index discharges during 2006–2014. Methods: Population-based data on maintenance therapies and rehospitalizations were extracted from Swedish national registries. We adopted the within-individual design to compare the time on- vs. off- maintenance therapy for males and females, respectively. Extended stratified Cox proportional hazards... (More)
Background: Long-term pharmacological maintenance therapy is often essential among people with bipolar disorder to reduce the need for inpatient care. Sex-specific responses to maintenance therapies are expected but remain largely unknown. Here, we examined for sex-specific associations between common maintenance therapies for bipolar disorder with inpatient rehospitalizations following patients' index discharges during 2006–2014. Methods: Population-based data on maintenance therapies and rehospitalizations were extracted from Swedish national registries. We adopted the within-individual design to compare the time on- vs. off- maintenance therapy for males and females, respectively. Extended stratified Cox proportional hazards regression models were employed to quantify the rate of rehospitalization as a function of common maintenance drugs and other important time-varying control variables. Results: Our primary analysis included 22,681 bipolar disorder rehospitalizations by 6,400 males and 9,588 (60.0%) females over an observation time of 62,813 person-years. The time spent on- vs. off- maintenance lithium, lamotrigine, quetiapine, or olanzapine was statistically significant upon adjustment among either sex for reducing the rate of bipolar rehospitalizations. Adjusted sex-specific statistically significant associations were also observed. Among females, the time on- (vs. off-) long-acting injectable risperidone reduced the rate of bipolar rehospitalizations by 73% (56–84%), carbamazepine by 44% (18–62%), aripiprazole by 29% (13–42%), and valproate by 23% (11–33%); whereas among males, ziprasidone by 65% (41–79%). Conclusion: The effectiveness of most maintenance therapies is generally comparable and uniform among both males and females. Despite some statistically significant sex-specific associations, estimates for each drug were fairly consistent between sexes.
(Less)
- author
- Ragazan, Dragos C. ; Eberhard, Jonas LU and Berge, Jonas LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- bipolar disorder, maintenance therapy, pharmacoepidemiogy, register, rehospitalization, sex-based analysis, sex-based differences
- in
- Frontiers in Psychiatry
- volume
- 11
- article number
- 598946
- publisher
- Frontiers Media S. A.
- external identifiers
-
- scopus:85096764972
- pmid:33262715
- ISSN
- 1664-0640
- DOI
- 10.3389/fpsyt.2020.598946
- language
- English
- LU publication?
- yes
- id
- 4bf8c603-c7f7-41ab-8e7a-174c2bd60882
- date added to LUP
- 2021-01-15 12:51:26
- date last changed
- 2024-06-13 05:28:49
@article{4bf8c603-c7f7-41ab-8e7a-174c2bd60882, abstract = {{<p>Background: Long-term pharmacological maintenance therapy is often essential among people with bipolar disorder to reduce the need for inpatient care. Sex-specific responses to maintenance therapies are expected but remain largely unknown. Here, we examined for sex-specific associations between common maintenance therapies for bipolar disorder with inpatient rehospitalizations following patients' index discharges during 2006–2014. Methods: Population-based data on maintenance therapies and rehospitalizations were extracted from Swedish national registries. We adopted the within-individual design to compare the time on- vs. off- maintenance therapy for males and females, respectively. Extended stratified Cox proportional hazards regression models were employed to quantify the rate of rehospitalization as a function of common maintenance drugs and other important time-varying control variables. Results: Our primary analysis included 22,681 bipolar disorder rehospitalizations by 6,400 males and 9,588 (60.0%) females over an observation time of 62,813 person-years. The time spent on- vs. off- maintenance lithium, lamotrigine, quetiapine, or olanzapine was statistically significant upon adjustment among either sex for reducing the rate of bipolar rehospitalizations. Adjusted sex-specific statistically significant associations were also observed. Among females, the time on- (vs. off-) long-acting injectable risperidone reduced the rate of bipolar rehospitalizations by 73% (56–84%), carbamazepine by 44% (18–62%), aripiprazole by 29% (13–42%), and valproate by 23% (11–33%); whereas among males, ziprasidone by 65% (41–79%). Conclusion: The effectiveness of most maintenance therapies is generally comparable and uniform among both males and females. Despite some statistically significant sex-specific associations, estimates for each drug were fairly consistent between sexes.</p>}}, author = {{Ragazan, Dragos C. and Eberhard, Jonas and Berge, Jonas}}, issn = {{1664-0640}}, keywords = {{bipolar disorder; maintenance therapy; pharmacoepidemiogy; register; rehospitalization; sex-based analysis; sex-based differences}}, language = {{eng}}, publisher = {{Frontiers Media S. A.}}, series = {{Frontiers in Psychiatry}}, title = {{Sex-Specific Associations Between Bipolar Disorder Pharmacological Maintenance Therapies and Inpatient Rehospitalizations : A 9-Year Swedish National Registry Study}}, url = {{http://dx.doi.org/10.3389/fpsyt.2020.598946}}, doi = {{10.3389/fpsyt.2020.598946}}, volume = {{11}}, year = {{2020}}, }