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Hospitalized elderly: investigating newly prescribed atypical antipsychotics during the hospital stay and their continuation on discharge

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Abstract

Background

Atypical antipsychotics are commonly used in hospital for a variety of indications. Because of their association with increased mortality in elderly patients with dementia, their use should be limited to the lowest possible doses for the shortest period of time.

Objectives

This study aimed to determine the proportion of elderly patients started on atypical antipsychotics in hospital and continued on discharge, to describe the indications for their use, as well as the presence of documented follow-up post-discharge.

Methods

This was a retrospective, observational study using electronic health record data of 100 patients admitted to Winchester District Memorial Hospital between November 2017 and July 2018. Patients 65 years of age or older who were started on an atypical antipsychotic during their hospital stay were eligible for inclusion.

Results

Of the 100 selected elderly patients, 43% were prescribed an atypical antipsychotic in a hospital and received a prescription for an atypical antipsychotic on discharge. Of those prescribed atypical antipsychotics on discharge, 56% had no documented follow-up plan addressing this medication. The most common indications for starting atypical antipsychotics in these patients as noted on the discharge summary were delirium (40%) and agitation (23%); 12% were undocumented.

Conclusions

Despite the risks of atypical antipsychotics in the elderly, a large proportion of patients who were newly prescribed atypical antipsychotics in hospital were prescribed these medications on discharge. While the majority of these patients did have an indication for starting an atypical antipsychotic documented in the discharge summary, a plan to follow-up with this medication as an outpatient was commonly absent.

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Acknowledgements

We would like to acknowledge the hospital research team at the Winchester District Memorial Hospital for critically reviewing our study protocol.

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Authors and Affiliations

  1. Winchester, Canada

    Ali Elbeddini

  2. Leslie Dan School of Pharmacy, 144 College St, Toronto, ON, M5S 3M2, Canada

    Anthony To

Authors
  1. Ali Elbeddini
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  2. Anthony To
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Contributions

AE searched the literature, conceptualized the study, collected and analyzed data, and wrote the manuscript. AT contributed to the preparation, content, writing, and revision of the manuscript.

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Funding

The authors declare that no funding was received for this study.

Conflict of interest

AE and AT have no conflicts of interest to declare relevant to the contents of this article.

Disclosure of financial relationships

No financial support received from any institution.

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Elbeddini, A., To, A. Hospitalized elderly: investigating newly prescribed atypical antipsychotics during the hospital stay and their continuation on discharge. Drugs Ther Perspect 36, 421–425 (2020). https://doi.org/10.1007/s40267-020-00760-8

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  • DOI: https://doi.org/10.1007/s40267-020-00760-8

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