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

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dc.contributor.authorWalsh, Kieran A.
dc.contributor.authorO'Regan, Niamh A.
dc.contributor.authorByrne, Stephen
dc.contributor.authorBrowne, John P.
dc.contributor.authorMeagher, David J.
dc.contributor.authorTimmons, Suzanne
dc.contributor.funderHealth Research Boarden
dc.contributor.funderAtlantic Philanthropiesen
dc.date.accessioned2016-11-22T15:32:11Z
dc.date.available2016-11-22T15:32:11Z
dc.date.issued2016-11
dc.date.updated2016-11-22T15:23:23Z
dc.description.abstractNeuropsychiatric 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.sponsorshipHealth 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationWalsh, 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/S1041610216001307en
dc.identifier.doi10.1017/S1041610216001307
dc.identifier.endpage1820en
dc.identifier.issn1741-203X
dc.identifier.issued11en
dc.identifier.journaltitleInternational psychogeriatrics / IPAen
dc.identifier.startpage1807en
dc.identifier.urihttps://hdl.handle.net/10468/3303
dc.identifier.volume28en
dc.language.isoenen
dc.publisherCambridge University Pressen
dc.rightsCOPYRIGHT: © 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.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectDementiaen
dc.subjectDeliriumen
dc.subjectAnti-psychoticsen
dc.subjectBehavioral and psychological symptoms of dementia (BPSD)en
dc.subjectNeuropsychiatric symptoms (NPS)en
dc.titlePatterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribingen
dc.typeArticle (peer-reviewed)en
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