Table 2 Weekly number of defined daily doses of medicines per 1000 resident-days during the study period and summary of trends in individuals who did and did not receive an RMMR in the 6–12 months after RACF entry
Medicine class | RMMR exposure status | Weekly DDDs/1000 resident-days | Summary of trends | ||
|---|---|---|---|---|---|
17-weeks before index date | Week of index date | 17-weeks after index date | |||
Antidepressantsa | RMMR | 459.3 | 491.7 | 488.0 | • During the pre-intervention period and washout periods, antidepressant use was increasing at a similar rate in both groups • During follow-up, use plateaued in the RMMR group, but continued to slowly increase in those without an RMMR (-0.34 vs. 0.66 DDDs/1000 days per week, p < 0.001) |
No RMMR | 434.5 | 460.5 | 468.7 | ||
Antipsychotics | RMMR | 67.0 | 67.4 | 67.0 | • Differences in weekly trends between groups during the pre-intervention and follow-up periods were negligible (≤ 0.1 DDDs/1000 days per week) |
No RMMR | 64.1 | 65.8 | 66.6 | ||
Benzodiazepines or zopiclone | RMMR | 102.2 | 106.0 | 99.9 | • During the pre-intervention period, benzodiazepine/zopiclone use increased at a similar rate in both groups (p = 0.524) • Use declined more quickly in the RMMR group during the washout and follow-up periods, but the differences in trends were negligible (0.4 DDDs/1000 days per week, p = 0.001) |
No RMMR | 96.7 | 100.1 | 99.6 | ||
Opioids | RMMR | 87.5 | 101.0 | 101.5 | • During the pre-intervention period, opioid use increased in those with and without an RMMR, with only a negligible difference between groups of 0.1 DDDs/1000 days per week • Opioid use plateaued after the index date with no difference in trends between the two groups (p > 0.05) |
No RMMR | 86.6 | 96.9 | 97.3 | ||
Medicines for cognitive symptoms of dementia | RMMR | 119.0 | 113.8 | 112.4 | • There were no significant differences in use between the two groups during the pre-intevention and washout periods (all p > 0.05) • A small difference in weekly use between groups during the follow-up period (-0.7 vs. -0.4 DDDs/1000 days per week, p = 0.03) was observed. Cautious interpretation is advised due to considerable variation in use (weekly differences of up to 10 DDDs/1000 days) observed in the RMMR group during follow-up |
No RMMR | 116.2 | 112.6 | 111.4 | ||
Proton pump inhibitorsa | RMMR | 489.0 | 499.5 | 466.2 | • During the pre-intervention period, PPI use was increasing at a similar rate in both groups (p = 0.596) • During the washout period, PPI use declined faster in the RMMR group (-2.6 vs. -1.5 DDDs/1000 days per week, p = 0.001) • At the start of the follow-up period, the rate of PPI use in the RMMR group dropped below the rate among those without an RMMR (-14.0 vs. -2.8 DDDs/1000 days, p < 0.001) and continued to decline at the same rate in both groups thereafter (p = 0.334) |
No RMMR | 477.9 | 488.7 | 474.3 | ||
Osteoporosis medicines | RMMR | 151.1 | 152.9 | 151.6 | • There were no significant differences in use between the two groups during the pre-intevention, washout and follow-up periods (all p > 0.05) • In the first week of the follow-up period, a significant drop in use was observed in the RMMR group (-3.0 vs. 0.04 DDDs/1000 days, p = 0.001). However, this was influenced by an outlier observation at the end of the follow-up period |
No RMMR | 150.6 | 147.1 | 145.8 | ||
Glucose lowering medicines | RMMR | 282.2 | 262.4 | 249.7 | • Use decreased at a similar rate in both groups during the pre-intervention, washout and follow-up periods (all p > 0.05) |
No RMMR | 292.9 | 261.5 | 251.3 | ||
Statinsa | RMMR | 502.1 | 483.1 | 433.6 | • Significant decrease in statin use in the RMMR group post-index date; refer to Table 3 and description in “Results“ section |
No RMMR | 492.2 | 476.7 | 451.8 | ||
ACE inhibitors or sartans | RMMR | 636.4 | 628.4 | 608.2 | • ACE inhibitor/sartan use decreased at a similar rate in both groups during the pre-intervention and follow-up periods (p > 0.05) • There was a slightly faster rate of decline in the RMMR group during the washout period (-3.7 vs -1.6 DDDs/1000 days per week, p = 0.01). However, this was influenced by an outlier observation in the first week of the washout period |
No RMMR | 609.2 | 601.7 | 597.5 | ||
Beta blockers | RMMR | 137.8 | 131.8 | 125.0 | • Differences in weekly trends between groups during the pre-intervention, washout and follow-up periods were negligible (≤ 0.4 DDDs/1000 days per week) |
No RMMR | 130.3 | 132.5 | 124.8 | ||
Calcium channel blockers (CCBs)a | RMMR | 241.6 | 243.3 | 228.0 | • CCB use decreased at a similar rate in both groups during the pre-intervention and washout periods (p = 0.435) • At the start of the follow-up period, CCB in the RMMR group dropped below the rate in the group without an RMMR (-4.2 versus 2.1 DDDs/1000 days, p < 0.001), but declined more quickly among those without an RMMR during follow-up (-0.12 vs. -0.62 DDDs/1000 days per week, p < 0.001) |
No RMMR | 241.2 | 240.6 | 232.3 | ||
Loop diuretics | RMMR | 376.4 | 395.8 | 385.2 | • During the pre-intervention period, use was increasing at a slightly faster rate among individuals RMMR (0.92 vs. 1.8 DDDs/1000 days per week, p = 0.015). However, use declined during the washout and follow-up periods, with no differences in trends observed between the two groups (p > 0.05) |
No RMMR | 355.9 | 386.7 | 366.6 | ||
Oral anticoagulants | RMMR | 74.8 | 74.1 | 68.0 | • Use was stable during the pre-intervention period, with only a negligible difference between groups (< 0.1 DDDs/1000 days per week) • Oral anticoagulant use declined at a similar rate in both groups after the index date (p > 0.05) |
No RMMR | 72.0 | 71.9 | 65.6 | ||