ArticleJournal of hospital medicine2016
Antipsychotic medication utilization in nonpsychiatric hospitalizations.
Article in Journal of hospital medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Exploring Antipsychotic Use for Delirium Management in Adults in Hospital, Sub-Acute Rehabilitation and Aged Care Settings: A Systematic Literature Review.Drugs & aging · 2024Pooled it
- Evaluation of the Efficacy and Safety of Quetiapine in the Treatment of Delirium in Adult ICU Patients: A Retrospective Comparative Study.Journal of clinical medicine · 2024Article
- Trends in use of antipsychotics and psychoactive drugs in older patients after major surgery.Journal of the American Geriatrics Society · 2023Article
- Article
- Antipsychotic medications for older adults with delirium admitted to hospital.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.Journal of the American Geriatrics Society · 2023Article
- Article
- Potentially inappropriate medication among older patients with diabetic kidney disease.Frontiers in pharmacology · 2023Article
- Opioid and Sedative Coprescription: Prescribing Patterns after an ICU Admission.The Canadian journal of hospital pharmacy · 2023Article
- New Antipsychotic Prescribing Continued into Skilled Nursing Facilities Following a Heart Failure Hospitalization: a Retrospective Cohort Study.Journal of general internal medicine · 2022Article
- Prevention and Management of Delirium in the Intensive Care Unit.Seminars in respiratory and critical care medicine · 2021Article
- Psychotropic Drug-Associated Pneumonia in Older Adults.Drugs & aging · 2020Review
- Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults.Journal of the American Geriatrics Society · 2020Article
- Rates of new antipsychotic prescriptions and continuation at discharge from a medical unit in a community teaching hospital serving rural counties.The mental health clinician · 2019Article
- Longitudinal Trends and Variation in Antipsychotic Use in Older Adults After Cardiac Surgery.Journal of the American Geriatrics Society · 2018Article
- Antipsychotics and the Risk of Aspiration Pneumonia in Individuals Hospitalized for Nonpsychiatric Conditions: A Cohort Study.Journal of the American Geriatrics Society · 2017Article
- Evaluation of algorithms to identify delirium in administrative claims and drug utilization database.Pharmacoepidemiology and drug safety · 2017Article
- Epidemiology of Vasopressin Use for Adults with Septic Shock.Annals of the American Thoracic Society · 2016Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAlthough antipsychotics are used for treatment of delirium/agitation in hospitalized patients, their scope of use has not been investigated in a large, multicenter cohort.
objectiveTo determine rates of use and hospital variation in use of antipsychotics in nonpsychiatric admissions. DESIGN, SETTING, PATIENTS: Cohort study of adult, nonpsychiatric admissions to 300 US hospitals contributing data to the Premier database, from July 1, 2009 to June 30, 2010. MEASUREMENTS: Antipsychotic exposure defined using pharmacy charges. Potentially excessive dosing defined using guidelines for long-term care facilities.
resultsOur cohort included 2,695,081 admissions (median age, 63 years; 56% female). Antipsychotic exposure occurred in 160,773 (6%) admissions; 102,148 (64%) received atypical antipsychotics, 76,979 (48%) received typical, and 18,354 (11%) received both. Among exposed admissions, 47% received ≥1 potentially excessive daily dose. Among the variables we analyzed, the strongest predictors of antipsychotic receipt were delirium (relative risk [RR]: 2.93, 95% CI: 2.88-2.98) and dementia (RR: 2.78, 95% CI: 2.72-2.83). After adjustment for patient characteristics, patients admitted to hospitals in the highest antipsychotic prescribing quintile were more than twice as likely to be exposed compared to patients admitted to hospitals in the lowest prescribing quintile (RR: 2.56, 95% CI: 2.50-2.61). This relationship was similar across subgroups of admissions with delirium and dementia.
conclusionsAntipsychotic medication exposure is common in nonpsychiatric admissions to US hospitals. The observed variation in antipsychotic prescribing was not fully explained by measured patient characteristics, suggesting the possibility of differing hospital prescribing cultures. Additional research and guidelines are necessary to define appropriate use of these potentially harmful medications in the hospital setting. Journal of Hospital Medicine 2016;11:543-549. © 2016 Society of Hospital Medicine.
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