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Adherence to psychotropic medication in completed suicide in Sweden 2006–2013: a forensic-toxicological matched case-control study
- Source :
- European Journal of Clinical Pharmacology. 75:1421-1430
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- To investigate the influence of adherence to psychotropic medications upon the risk of completed suicide by comparing person-level prescriptions and postmortem toxicological findings among complete-suicide cases and non-suicide controls in Sweden 2006–2013. Using national registries with full coverage on dispensed prescriptions, results of medico-legal autopsies, causes of death, and diagnoses from inpatient care, estimated continuous drug use for 30 commonly prescribed psychotropic medications was compared with forensic-toxicological findings. Subjects who had died by suicide (cases) were matched (1:2) with subjects who had died of other causes (controls) for age, sex, and year of death. Odds ratios were calculated using logistic regression to estimate the risk of completed suicide conferred by partial adherence and non-adherence to pharmacotherapy. Adjustments were made for previous inpatient care and the ratio of initiated and discontinued dispensed prescriptions, a measure of the continued need of treatment preceding death. In 5294 suicide cases and 9879 non-suicide controls, after adjusting for the dispensation ratio and other covariates, partial adherence and non-adherence to antipsychotics were associated with 6.7-fold and 12.4-fold risks of completed suicide, respectively, whereas corresponding risk estimates for antidepressant treatment were not statistically significant and corresponding risk increases for incomplete adherence to antidepressant treatment were lower (1.6-fold and 1.5-fold, respectively) and lacked statistical significance. After adjustment for the need of treatment, biochemically verified incomplete adherence to antipsychotic pharmacotherapy was associated with markedly increased risks of completed suicide.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Logistic regression
030226 pharmacology & pharmacy
Medication Adherence
03 medical and health sciences
0302 clinical medicine
Pharmacotherapy
Statistical significance
Internal medicine
Suicide, Completed
medicine
Humans
Pharmacology (medical)
Registries
030212 general & internal medicine
Medical prescription
Antipsychotic
Aged
Sweden
Pharmacology
Psychotropic Drugs
business.industry
Case-control study
General Medicine
Odds ratio
Middle Aged
Pharmacoepidemiology
Case-Control Studies
Female
business
Subjects
Details
- ISSN :
- 14321041 and 00316970
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- European Journal of Clinical Pharmacology
- Accession number :
- edsair.doi.dedup.....53cb072c38e3548edb655be7aa141b86