Relationship between obesity and antipsychotic drug use in the adult population: A longitudinal, retrospective claim database study in Primary Care settings

Figures & data

Table 1 General characteristics of the study sample in the absence or presence of obesity

Sudy variables	Nonobese (n = 30,843)	Obese (n = 11,594)	Total (n = 42,437)	P
Subjects treated with APDs (%)	n = 344 (1.1%)	n = 207 (1.8%)	n = 551 (1.3%)	<0.0001
General
Mean age (SD), years	48.2 (18.8)	57.9 (15.5)	50.8 (18.4)	<0.0001
Sex (females)	52.4	59.9	54.5	<0.0001
Mean visits/year	9.1 (8.5)	12.1 (9.8)	10.0 (9.0)	<0.0001
Body mass index (SD), kg/m^2	25.0 (3.0)	33.8 (3.6)	27.4 (5.1)	<0.0001
Mean episodes/year	5.4 (3.6)	7.0 (4.0)	5.9 (3.8)	<0.0001
Mean Charlson Index	0.3 (0.6)	0.5 (0.7)	0.4 (0.6)	<0.0001
Antecedents or associated comorbidities
Arterial hypertension	19.9	47.0	27.3	<0.0001
Dyslipidemia	22.6	35.9	26.3	<0.0001
Diabetes mellitus	9.0	19.0	11.7	<0.0001
Smokers	29.2	18.5	26.3	<0.0001
Ischemic heart disease	3.5	6.2	4.3	<0.0001
Stroke	2.0	2.3	2.1	0.042
Cardiovascular events	6.3	9.2	7.1	<0.0001
Alcoholism	1.9	1.7	1.8	NS
Chronic obstructive pulmonary disease	2.9	4.5	3.4	<0.0001
Bronchial asthma	3.8	4.7	4.1	<0.0001
Clinical parameters
Systolic blood pressure (SD), mmHg	127.0 (16.6)	135.2 (16.1)	129.6 (16.9)	<0.0001
Diastolic blood pressure (SD), mmHg	75.1 (9.5)	79.5 (9.4)	76.5 (9.7)	<0.0001
Baseline blood glucose (SD), mg/dl	95.1 (25.5)	106.6 (32.8)	98.5 (28.4)	<0.0001
Serum triglycerides (SD), mg/dl	112.3 (75.2)	140.6 (89.7)	121.5 (81.3)	<0.0001
Total cholesterol (SD), mg/dl	204.9 (45.3)	221.4 (42.3)	217.7 (43.6)	<0.0001
HDL-cholesterol (SD), mg/dl	48.3 (13.7)	44.0 (12.0)	46.9 (13.3)	<0.0001
LDL-cholesterol (SD), mg/dl	138.0 (36.1)	143.1 (34.3)	139.6 (35.6)	<0.0001

Notes: Values are given as percentage or mean.

Abbreviations: SD, standard deviation; p, statistical significance; NS, nonsignificant; APD, antipsychotic drug; HDL-cholesterol, high density lipoprotein cholesterol; LDLcholesterol, low density lipoprotein cholesterol.

Table 2 Results of the logistic regression model with obesity as dependent variable

Vriables of the model	Beta	p	OR	95%CI
Antipsychotics use	0.421	<0.0001	1.5	1.3 – 1.8
Age (years)	0.132	<0.0001	1.2	1.1 – 1.3
Sex (male)	−0.272	<0.0001	0.8	0.7 – 0.8
Arterial hypertension	0.864	<0.0001	2.4	2.2 – 2.5
Diabetes mellitus	0.323	<0.0001	1.4	1.3 – 1.5
Dyslipidemia	0.272	<0.0001	1.3	1.2 – 1.4

Abbreviations: OR, odds ratio; CI, 95% confidence interval.

Table 3 Overall characteristics and clinical parameters of the patients included in the study according to the use of antipsychotic drugs (APDs)

General concepts	No APDs (n = 41,886)	APDs (n = 551)	P
Characteristics
Sex (females)	54.5%	56.4%	NS
Mean age (SD), years	50.7 (18.4)	56.4 (19.5)	<0.0001
Body Mass Index (SD), kg/m^2	27.3 (5.1)	28.8 (5.7)	<0.0001
Mean visits/year (SD)	9.8 (8.9)	14.8 (11.3)	<0.0001
Mean episodes/year (SD)	5.9 (3.8)	7.1 (4.3)	<0.0001
Mean Charlson Index (SD)	0.3 (0.6)	0.5 (0.7)	<0.0001
Clinical parameters
Systolic blood pressure (SD), mmHg	129.6 (16.9)	128.2 (15.8)	NS
Diastolic blood pressure (SD), mmHg	76.5 (9.7)	75.9 (9.4)	NS
Baseline blood glucose (SD), mg/dl	98.4 (28.3)	102.1 (35.0)	0.006
Serum triglycerides (SD), mg/dl	121.2 (81.1)	139.6 (90.5)	<0.0001
Total cholesterol (SD), mg/dl	206.8 (41.5)	207.9 (42.2)	NS
HDL-cholesterol (SD), mg/dl	46.9 (13.3)	43.6 (12.6)	<0.0001
LDL-cholesterol (SD), mg/dl	139.6 (35.6)	139.8 (34.5)	NS

Notes: values are given as percentage or mean.

Abbreviations: SD, standard deviation; NS, nonsignificant; HDL-cholesterol, high density lipoprotein cholesterol; LDL-cholesterol, low density lipoprotein cholesterol.

Table 4 General and unit distribution of the model of costs per patient per year (in euros), in the absence or presence of obesity

			Nonobese	(n = 30.843)	Obese subjects	(n = 11.594)
Concepts	Total costs		Mean (SD)	Corrected model*	Mean (SD)	Corrected model*	Mean total cost per patient	P*
Total cost in PC	27,696,430		638 (1.245)	694 [679–709]	981 (1.467)	811 [787–835]	735 (1.320)	<0.0001
Fixed/semifixed cost	7,511,580	(27%)	182 (170)	192 [190–194]	242 (196)	212 [209–215]	199 (180)	<0.0001
Variable cost	20,184,850	(73%)	455 (1.182)	502 [488–516]	739 (1.395)	599 [575–622]	535 (1.253)	<0.0001
Cost of referrals	2,211,296	(8%)	54 (76)	56 [55–57]	70 (86)	64 [62–65]	59 (79)	<0.0001
Pharmaceutical cost	16,460,466	(59%)	363 (673)	407 [400–414]	624 (807)	497 [485–510]	437 (723)	<0.0001

Notes: Values are given as percentage or mean; costs in euros ();

* adjusted p level; each F-test contrasts the simple effect of obesity in each combination of levels of the rest of effects shown. These contrasts are based on comparisons by pairs (linearly independent), between the estimated marginal means. The co-variables appearing in the model are evaluated in the following values: Charlson Index = 0.35, mean age =52.2. Method: Bonferroni correction.

Abbreviations: SD, standard deviation and 95% confidence interval; PC, Primary Care.