To investigate whether donepezil is associated with a greater risk of hospitalization for malignant arrhythmias compared to other AChEIs.
Approach:
Study Design: A population-based retrospective cohort study of individuals aged 66 and over in seven Canadian provinces using linked healthcare databases.
Data Sources: Utilized the National Prescription Drug Utilization Information System (NPDUIS) for prescription claims and the Discharge Abstract Database (DAD) for hospital encounters.
Cohort Definition: Included individuals aged 66 and over with a newly dispensed AChEI between April 1, 2011, and January 31, 2019, excluding those with prior malignant arrhythmia hospitalizations.
Exposure and Follow-Up: Primary exposure was initiation of donepezil, with follow-up from the first prescription to the last, including a grace period for prescription gaps.
Outcome Definition: Primary outcome was hospitalization for a malignant arrhythmia, specifically ventricular tachycardia.
Key Findings:
Donepezil is associated with a higher risk of hospitalization for malignant arrhythmias compared to other AChEIs.
The study utilized a comprehensive dataset covering multiple provinces and a significant time frame.
Interpretation:
The findings suggest a potential increased risk of serious cardiac events associated with donepezil use in older adults.
Limitations:
The study is retrospective and may be subject to confounding factors.
Data was limited to publicly funded prescriptions and hospitalizations.
Conclusion:
The study highlights the need for careful monitoring of cardiac health in patients prescribed donepezil.
