Temporal Trends Over Two Decades in the Use of Anticholinergic Drugs Among Older Community-Dwelling People in Helsinki, Finland

Background Knowledge of the adverse effects of drugs with anticholinergic properties (DAPs) has increased in recent decades. However, research on the temporal trends of the clinical use of DAPs is still sparse. Objectives The aim of this study was to investigate the temporal trends of DAP use over two decades in the older community-dwelling population and to explore the medication classes contributing to the use of DAPs. Methods The study involved random samples of >= 75-year-old community-dwelling Helsinki citizens in 1999, 2009, and 2019 from the Helsinki Ageing Study. A postal questionnaire inquired about their health, functioning, and medications. The medications were categorized as DAPs according to Duran's list. In addition, we grouped DAPs into various medication groups. Results The prevalence and burden of DAPs on Duran's list showed a decreasing trend over the years. In 1999 the prevalence was 20% and the burden 0.35, in 2009 they were 22% and 0.35, respectively, and in 2019 they were 16% and 0.23, respectively. There were no differences in how the 75- and 80-year-olds used DAPs compared with those aged 85 years and older. The proportion of typical antipsychotics, benzodiazepines, hypnotics, urinary antispasmodics, and asthma/chronic obstructive pulmonary disease medications decreased, whereas the proportion of atypical antipsychotics, antidepressants, strong opioids, and antihistamines increased. In particular the use of mirtazapine increased-to 3.9% in 2019. In 2019 the three most prevalent groups of DAPs were antidepressants (7.4%), opioids (2.7%), and antihistamines (2.4%). Conclusions The decrease in the use of DAPs on Duran's list is a welcome change. Although the use of old, strong DAPs has decreased, new DAPs have simultaneously emerged. Physicians need continuous education in prescribing DAPs and more recent information on the use and effects of DAPs is needed in order to decrease their exposure among the rapidly growing older population.Peer reviewe

Business ecosystem perspective on innovation policy:a case study of San Diego life sciences

Abstract This paper applies a business ecosystem perspective to analyse innovation policy. The research utilised a case study on San Diego, which is one of the top three life sciences ecosystems in the world. Unlike previous studies, this research is an analysis of the ecosystem’s evolution in each life-cycle phase—birth, expansion, leadership and self-renewal—and the key innovation policy measures related to these phases. The findings indicate that traditional policy measures must be reconsidered in the era of business ecosystems

Innovative regional development through triple helix collaboration:a comparative case study of strategic structures and implementation

Abstract Intense global competition forces regions to seek new ways to boost innovativeness and the success of local enterprises. This paper focuses on triple helix collaboration to support regional innovation-led development and economy. Various options exist for structuring and implementing triple helix collaboration. However, current empirical knowledge is inadequate for stakeholders interested and involved in regional strategy creation and implementation. This study analyses the strategic structures and implementation of triple helix collaboration in two regional cases: Brainport (Netherlands) and Oulu innovation alliance (OIA, Finland). Case Brainport introduces a holistic approach and high profile role in regional development, whereas case OIA demonstrates the knowledge institutes’ role in regional development in five spearhead areas. The cases illustrate two empirical ways to utilise triple helix mandate and strategic structures in regional development and strategy processes. The case comparison demonstrates diverse options for organising triple helix collaboration

Temporal trends over two decades in the use of anticholinergic drugs among older community-dwelling people in Helsinki, Finland

Abstract Background: Knowledge of the adverse effects of drugs with anticholinergic properties (DAPs) has increased in recent decades. However, research on the temporal trends of the clinical use of DAPs is still sparse. Objectives: The aim of this study was to investigate the temporal trends of DAP use over two decades in the older community-dwelling population and to explore the medication classes contributing to the use of DAPs. Methods: The study involved random samples of ≥ 75-year-old community-dwelling Helsinki citizens in 1999, 2009, and 2019 from the Helsinki Ageing Study. A postal questionnaire inquired about their health, functioning, and medications. The medications were categorized as DAPs according to Duran’s list. In addition, we grouped DAPs into various medication groups. Results: The prevalence and burden of DAPs on Duran’s list showed a decreasing trend over the years. In 1999 the prevalence was 20% and the burden 0.35, in 2009 they were 22% and 0.35, respectively, and in 2019 they were 16% and 0.23, respectively. There were no differences in how the 75- and 80-year-olds used DAPs compared with those aged 85 years and older. The proportion of typical antipsychotics, benzodiazepines, hypnotics, urinary antispasmodics, and asthma/chronic obstructive pulmonary disease medications decreased, whereas the proportion of atypical antipsychotics, antidepressants, strong opioids, and antihistamines increased. In particular the use of mirtazapine increased—to 3.9% in 2019. In 2019 the three most prevalent groups of DAPs were antidepressants (7.4%), opioids (2.7%), and antihistamines (2.4%). Conclusions: The decrease in the use of DAPs on Duran’s list is a welcome change. Although the use of old, strong DAPs has decreased, new DAPs have simultaneously emerged. Physicians need continuous education in prescribing DAPs and more recent information on the use and effects of DAPs is needed in order to decrease their exposure among the rapidly growing older population