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Antipsychotic polypharmacy among patients admitted to a geriatric psychiatry unit.
J Psychiatr Pract. 2011 Sep; 17(5):368-74.JP

Abstract

OBJECTIVES

This study describes the prevalence of antipsychotic polypharmacy in patients admitted to a geriatric psychiatry unit, compares polypharmacy by psychiatric diagnosis, explores predictors of polypharmacy, and examines changes in antipsychotic polypharmacy from baseline to discharge.

METHODS

A retrospective examination was made of patients admitted to an inpatient geriatric psychiatry ward between 2006 and 2010. All patients with a diagnosis of schizophrenia, bipolar disorder, or dementia prescribed a regularly scheduled antipsychotic for at least 1 month prior to admission were included.

RESULTS

Of the 416 patients meeting selection criteria, nearly 13% were prescribed antipsychotic polypharmacy at the time of admission. Quetiapine was the antipsychotic most commonly involved in polypharmacy. By discharge, the rate of antipsychotic polypharmacy had decreased to 8% (X=4.74, df=1, p=0.03). Patients with a history of a severe mental illness were significantly more likely to have been prescribed antipsychotic polypharmacy compared with those with only a diagnosis of dementia (X=14.67, df=1, p=<0.001). Living situation and psychiatric diagnosis were significant predictors of antipsychotic polypharmacy.

CONCLUSION

Older adults admitted to a geriatric psychiatry ward on a scheduled antipsychotic were commonly prescribed more than one antipsychotic. This was most likely in patients living in a facility (e.g., assisted living, skilled nursing, long-term care) and in those patients with a severe mental illness. A better understanding of the efficacy and safety of antipsychotic polypharmacy in older adults, especially those with dementia, is necessary in order to use these medications rationally.

Authors+Show Affiliations

Wingate University School of Pharmacy, Wingate, NC 28174, USA. cdolder@wingate.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21926533

Citation

Dolder, Christian R., and Jonathan McKinsey. "Antipsychotic Polypharmacy Among Patients Admitted to a Geriatric Psychiatry Unit." Journal of Psychiatric Practice, vol. 17, no. 5, 2011, pp. 368-74.
Dolder CR, McKinsey J. Antipsychotic polypharmacy among patients admitted to a geriatric psychiatry unit. J Psychiatr Pract. 2011;17(5):368-74.
Dolder, C. R., & McKinsey, J. (2011). Antipsychotic polypharmacy among patients admitted to a geriatric psychiatry unit. Journal of Psychiatric Practice, 17(5), 368-74. https://doi.org/10.1097/01.pra.0000405368.20538.cd
Dolder CR, McKinsey J. Antipsychotic Polypharmacy Among Patients Admitted to a Geriatric Psychiatry Unit. J Psychiatr Pract. 2011;17(5):368-74. PubMed PMID: 21926533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antipsychotic polypharmacy among patients admitted to a geriatric psychiatry unit. AU - Dolder,Christian R, AU - McKinsey,Jonathan, PY - 2011/9/20/entrez PY - 2011/9/20/pubmed PY - 2012/2/1/medline SP - 368 EP - 74 JF - Journal of psychiatric practice JO - J Psychiatr Pract VL - 17 IS - 5 N2 - OBJECTIVES: This study describes the prevalence of antipsychotic polypharmacy in patients admitted to a geriatric psychiatry unit, compares polypharmacy by psychiatric diagnosis, explores predictors of polypharmacy, and examines changes in antipsychotic polypharmacy from baseline to discharge. METHODS: A retrospective examination was made of patients admitted to an inpatient geriatric psychiatry ward between 2006 and 2010. All patients with a diagnosis of schizophrenia, bipolar disorder, or dementia prescribed a regularly scheduled antipsychotic for at least 1 month prior to admission were included. RESULTS: Of the 416 patients meeting selection criteria, nearly 13% were prescribed antipsychotic polypharmacy at the time of admission. Quetiapine was the antipsychotic most commonly involved in polypharmacy. By discharge, the rate of antipsychotic polypharmacy had decreased to 8% (X=4.74, df=1, p=0.03). Patients with a history of a severe mental illness were significantly more likely to have been prescribed antipsychotic polypharmacy compared with those with only a diagnosis of dementia (X=14.67, df=1, p=<0.001). Living situation and psychiatric diagnosis were significant predictors of antipsychotic polypharmacy. CONCLUSION: Older adults admitted to a geriatric psychiatry ward on a scheduled antipsychotic were commonly prescribed more than one antipsychotic. This was most likely in patients living in a facility (e.g., assisted living, skilled nursing, long-term care) and in those patients with a severe mental illness. A better understanding of the efficacy and safety of antipsychotic polypharmacy in older adults, especially those with dementia, is necessary in order to use these medications rationally. SN - 1538-1145 UR - https://www.unboundmedicine.com/medline/citation/21926533/Antipsychotic_polypharmacy_among_patients_admitted_to_a_geriatric_psychiatry_unit_ L2 - http://dx.doi.org/10.1097/01.pra.0000405368.20538.cd DB - PRIME DP - Unbound Medicine ER -