Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing

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dc.contributor.author Walsh, Kieran A.
dc.contributor.author O'Regan, Niamh A.
dc.contributor.author Byrne, Stephen
dc.contributor.author Browne, John P.
dc.contributor.author Meagher, David J.
dc.contributor.author Timmons, Suzanne
dc.date.accessioned 2016-11-22T15:32:11Z
dc.date.available 2016-11-22T15:32:11Z
dc.date.issued 2016-11
dc.identifier.citation Walsh, Kieran A.; O'Regan, Niamh A.; Byrne, S.; Browne, J.; Meagher, David J.; Timmons, S. (2016) 'Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing'. International psychogeriatrics / IPA, 28 (11):1807-1820. doi: 10.1017/S1041610216001307 en
dc.identifier.volume 28 en
dc.identifier.issued 11 en
dc.identifier.startpage 1807 en
dc.identifier.endpage 1820 en
dc.identifier.issn 1741-203X
dc.identifier.uri http://hdl.handle.net/10468/3303
dc.identifier.doi 10.1017/S1041610216001307
dc.description.abstract 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. en
dc.description.sponsorship Health Research Board (grant number HRA HSR/2011/4, Cork Dementia Study, SPHeRE Programme under Grant No. SPHeRE/2013/1); Atlantic Philanthropies(SPHeRE Programme under Grant No. SPHeRE/2013/1) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Cambridge University Press en
dc.rights COPYRIGHT: © International Psychogeriatric Association 2016 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Dementia en
dc.subject Delirium en
dc.subject Anti-psychotics en
dc.subject Behavioral and psychological symptoms of dementia (BPSD) en
dc.subject Neuropsychiatric symptoms (NPS) en
dc.title Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Suzanne Timmons, Clinical Gerontology & Rehabilitation, University College Cork, Cork, Ireland. +353-21-490-3000 Email: s.timmons@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2016-11-22T15:23:23Z
dc.description.version Published Version en
dc.internal.rssid 362281922
dc.internal.pmid 27527842
dc.contributor.funder Health Research Board en
dc.contributor.funder Atlantic Philanthropies en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International psychogeriatrics / IPA en
dc.internal.copyrightchecked No en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress s.timmons@ucc.ie en
dc.internal.IRISemailaddress j.browne@ucc.ie en


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COPYRIGHT: © International Psychogeriatric Association 2016 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as COPYRIGHT: © International Psychogeriatric Association 2016 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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