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“Stat” Medication Administration Predicts Hospital Discharge

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Abstract

Objective This study describes the use of “stat” medications for inpatients in a large state psychiatric hospital system, and examines the relationship between receipt of a “stat” for agitation and subsequent hospital discharge. Methods Use of “stat” medications in 2005 was retrospectively determined using a database that contains diagnosis and prescription information from 17 state-run adult civil facilities. A logistic regression model explored the relationship between receipt of a “stat” order for intramuscular preparations of either antipsychotics or lorazepam within the first 30 days of hospitalization and likelihood of hospital discharge by 6 months. Results Among 7,202 patients who received antipsychotic medication in 2005, 3,240 (45%) also received a “stat” psychotropic medication during that year. Among 40,651 stat orders, 19,142 (47%) were for intramuscular antipsychotics or lorazepam presumably given for the treatment of agitation. Among 1,673 patients admitted in the first 6 months of 2005, 415 (25%) received at least one such “agitation stat.” The percent discharged at six months among “agitation stat” receivers was 39%, compared to 69% among those who did not receive an “agitation stat” (chi-square = 115, df = 1, P < .001). Regression analysis showed that receiving an “agitation stat” in the first 30 days of hospitalization was associated with a 37% lower likelihood of being discharged by 6 months after admission (odds ratio .63, 95% CI: .46–.86). Conclusions “Stat” medications are commonly used. The use of “agitation stat” medications can be used as a proxy for clinical stability and may prove to be a useful outcome measure for future pharmacoepidemiologic studies of comparative medication effectiveness.

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References

  1. Volavka J: Neurobiology of Violence, 2nd ed. Washington, DC: American Psychiatric Publishing, Inc., 2002

    Google Scholar 

  2. Citrome L: Agitation III: Pharmacologic Treatment of Agitation. Chapter 14. In: Glick RL, Berlin JS, Fishkind A, et al. (Eds) Emergency Psychiatry: Principles and Practice. Baltimore, MD: Lippincott Williams & Wilkins, Wolters Kluwer Health, pp. 137–147, 2008

    Google Scholar 

  3. Compton MT, Craw J, Rudisch BE: Determinants of inpatient psychiatric length of stay in an urban county hospital. Psychiatric Quarterly 77:173–188, 2006

    Article  PubMed  Google Scholar 

  4. LeGris J, Walters M, Browne G: The impact of seclusion on the treatment outcomes of psychotic in-patients. Journal of Advanced Nursing 30:448–459, 1999

    Article  Google Scholar 

  5. Mellesdal L: Aggression on a psychiatric acute ward: A three-year prospective study. Psychological Reports 92:1229–1248, 2003

    PubMed  Google Scholar 

  6. Citrome L, Green L, Fost R: Length of stay and recidivism on a psychiatric intensive care unit. Hospital and Community Psychiatry 45:74–76, 1994

    PubMed  CAS  Google Scholar 

  7. Citrome L, Jaffe A, Levine J: The ups and downs of dosing second-generation antipsychotics. Psychiatric Services 58:11, 2007

    Article  Google Scholar 

  8. Citrome L, Jaffe A, Levine J: Dosing of second-generation antipsychotic medication in a state hospital system. Journal of Clinical Psychopharmacology 25:388–391, 2005

    Article  PubMed  Google Scholar 

  9. Citrome L, Jaffe A, Levine J, et al.: Dosing of quetiapine in schizophrenia: How clinical practice differs from registration trials. Journal of Clinical Psychiatry 66:1512–1516, 2005

    Article  PubMed  Google Scholar 

  10. Citrome L, Levine J, Allingham B: Utilization of depot neuroleptic medication in psychiatric inpatients. Psychopharmacology Bulletin 32:321–326, 1996

    PubMed  CAS  Google Scholar 

  11. Levine J, Jaffe AB: Antipsychotic Medication Utilization in a State Mental Hospital System, 1994–2000 Chap. 15. In: Manderscheid RW, Henderson MJ (Eds) Mental Health United States 2002. Rockville, MD: Substance Abuse and Mental Health Services Administration, pp. 199–208, 2004. DHHS Pub Number (SMA) 3938

  12. Citrome L, Levine J, Allingham B: Utilization of valproate: Extent of inpatient use in the New York State Office of Mental Health. Psychiatric Quarterly 69:283–300, 1998

    Article  PubMed  CAS  Google Scholar 

  13. Citrome L, Levine J, Allingham B: Changes in use of valproate and other mood stabilizers for patients with schizophrenia from 1994 to 1998. Psychiatric Services 51:634–638, 2000

    Article  PubMed  CAS  Google Scholar 

  14. Citrome L, Jaffe A, Levine J, et al.: Use of mood stabilizers among patients with schizophrenia 1994–2001. Psychiatric Services 53:1212, 2002

    Article  PubMed  Google Scholar 

  15. Jaffe AB, Levine J: Antipsychotic medication coprescribing in a large state hospital system. Pharmacoepidemiology and Drug Safety 12:41–48, 2003

    Article  PubMed  Google Scholar 

  16. Citrome L, Jaffe A, Levine J, et al.: Relationship between antipsychotic medication treatment and new cases of diabetes among psychiatric inpatients. Psychiatric Services 55:1006–1013, 2004

    Article  PubMed  Google Scholar 

  17. Citrome L, Jaffe A, Levine J, et al.: Incidence, prevalence, and surveillance for diabetes in New York State psychiatric hospitals, 1997–2004. Psychiatric Services 57:1132–1139, 2006

    Article  PubMed  Google Scholar 

  18. Jaffe AB, Levine J: Efficacy and effectiveness of first- and second-generation antipsychotics in schizophrenia. Journal of Clinical Psychiatry 64(Suppl 17):3–6, 2003

    PubMed  CAS  Google Scholar 

  19. Javitt DC, Cienfuegos A, Miniati M, et al.: A naturalistic study of risperidone treatment outcome using prognosis-adjusted discharge rates in New York State inpatients. Journal of Clinical Psychiatry 63:585–590, 2002

    PubMed  Google Scholar 

  20. Voiral P, Robert P, Meister P, et al.: Psychotropic drug prescription in a psychiatric university hospital. Pharmacopsychiatry 32:29–37, 1999

    Article  Google Scholar 

  21. Craig TJ, Bracken J: An epidemiologic study of prn/stat medication use in a state psychiatric hospital. Annals of Clinical Psychiatry 7:57–64, 1995

    Article  PubMed  CAS  Google Scholar 

  22. McLaren S, Browne FW, Taylor P: A study of psychotropic medication given ‘as required’ in a regional secure unit. British Journal of Psychiatry 156:732–735, 1990

    Article  PubMed  CAS  Google Scholar 

  23. Walker R: PRN psychotropic drug use on a psychiatric unit. Psychiatric Quarterly 62:1–8, 1991

    Article  PubMed  CAS  Google Scholar 

  24. Citrome L: Compelling or irrelevant? Using number needed to treat can help decide. Acta Psychiatrica Scandinavica 117:412–419, 2008

    Article  CAS  Google Scholar 

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Acknowledgments

We thank Sara Bingel for her preliminary descriptive overview of the data, and Baerbel Allingham and David Martello for their meticulous work and technical expertise in the research use of data derived from operational databases. Partial support for the maintenance of the Integrated Research Database was provided by unrestricted grants from AstraZeneca and Eli Lilly & Co during the time of this study. The data has been presented as a poster at the following: 47th Meeting of the New Clinical Drug Evaluation Unit, Boca Raton, FL, June 11–14, 2007; 46th Meeting of the American College of Neuropsychopharmacology, Boca Raton, FL, December 9–13, 2007; 26th Congress of the Collegium Internationale Neuro-Psychopharmacologicum, Munich, Germany, July 13–17, 2008.

Disclosures Ari Jaffe has conducted clinical research supported by Eli Lilly and Company. Leslie Citrome is a consultant for, has received honoraria from, or has conducted clinical research supported by the following: AstraZeneca Pharmaceuticals, Azur Pharma Inc, Barr Laboratories, Eli Lilly and Company, Forest Research Institute, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Pfizer Inc, and Vanda Pharmaceuticals. Jerome Levine has no interests to disclose.

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Authors and Affiliations

  1. Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA

    Ari Jaffe, Jerome Levine & Leslie Citrome

  2. Department of Psychiatry, New York University School of Medicine, New York City, NY, USA

    Ari Jaffe, Jerome Levine & Leslie Citrome

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  1. Ari Jaffe
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  2. Jerome Levine
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  3. Leslie Citrome
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Correspondence to Leslie Citrome.

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Jaffe, A., Levine, J. & Citrome, L. “Stat” Medication Administration Predicts Hospital Discharge. Psychiatr Q 80, 65–73 (2009). https://doi.org/10.1007/s11126-009-9097-3

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  • DOI: https://doi.org/10.1007/s11126-009-9097-3

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