Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing.
Authors
Walsh, Kieran AnthonyO'Regan, Niamh A
Byrne, Stephen
Browne, John
Meagher, David J
Timmons, Suzanne
Affiliation
University College Cork, University of LimerickIssue Date
2016-08-16Keywords
OLDER PEOPLEDEMENTIA
MEDICINES
PRESCRIBING
Metadata
Show full item recordCitation
Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing. 2016:1-14 Int PsychogeriatrPublisher
Cambridge University PressJournal
International psychogeriatrics / IPADOI
10.1017/S1041610216001307PubMed ID
27527842Additional Links
http://journals.cambridge.org/action/displayFulltext?type=1&fid=10472839&jid=IPG&volumeId=-1&issueId=-1&aid=10472834Abstract
Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia.All older patients (≥ 70 years old) that had elective or emergency admissions to six Irish study hospitals were eligible for inclusion in a longitudinal observational study. Of 676 eligible patients, 598 patients were recruited and diagnosed as having dementia, or not, by medical experts. These 598 patients were assessed for delirium, medication use, co-morbidity, functional ability, and nutritional status. We conducted a retrospective cross-sectional analysis of medication data on admission for 583/598 patients with complete medication data, and controlled for age, sex, and co-morbidity.
Of 149 patients diagnosed with dementia, only 53 had a previous diagnosis. At hospital admission, 458/583 patients experienced polypharmacy (≥ 5 medications). People with dementia (PwD) were significantly more likely to be prescribed at least one psychotropic medication than patients without dementia (99/147 vs. 182/436; p < 0.001). PwD were also more likely to experience psychotropic polypharmacy (≥ two psychotropics) than those without dementia (54/147 vs. 61/436; p < 0.001). There were no significant differences in the prescribing patterns of anti-cholinergics (23/147 vs. 42/436; p = 0.18) or deliriogenics (79/147 vs. 235/436; p = 0.62).
Polypharmacy and psychotropic drug use is highly prevalent in older Irish hospitalized patients, especially in PwD. Hospital admission presents an ideal time for medication reviews in PwD.
Item Type
Article In PressLanguage
enISSN
1741-203XSponsors
Funder:SPHeRE/2013/1ae974a485f413a2113503eed53cd6c53
10.1017/S1041610216001307
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