Universität zu Köln

Moellers, Tobias, Perna, Laura, Stocker, Hannah, Ihle, Peter, Schubert, Ingrid, Schoettker, Ben, Froelich, Lutz and Brenner, Hermann ORCID: 0000-0002-6129-1572 (2020). New use of psychotropic medication after hospitalization among people with dementia. Int. J. Geriatr. Psychiatr., 35 (6). S. 640 - 650. HOBOKEN: WILEY. ISSN 1099-1166

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Abstract

Objectives Psychotropic medication is commonly used among people with dementia (PWD), but it shows modest efficacy and it has been associated with severe adverse events. Hospitalizations are an opportunity for medication management as well as treatment recommendations for outpatient physicians. The aim of this study was to asses factors associated with new use of psychotropic medication after hospitalization among PWD. Methods We conducted a retrospective dynamic cohort study from 2004 to 2015 using claims data from a German health insurance company. PWD were identified by an algorithm that included ICD-10 diagnosis and diagnostic measures. The medication classes included were antidepressants, antipsychotics, anxiolytics or hypnotics/sedatives, and Alzheimer's medication. The assessment period was up to 30 days after discharge from the hospital across four hospitalizations. Results The main predictors for new use of psychotropic medication were similar across medication classes. Neuropsychiatric symptoms (NPS) and the need of care were associated with higher odds of new use of antidepressants, antipsychotics, and anxiolytics or hypnotics/sedatives. A hospital stay due to dementia was an independent predictor for new use across medication classes as well. Delirium increased the odds for new use of antipsychotics and anxiolytics or hypnotics/sedatives. Conclusions Factors associated with new use of psychotropic medication included delirium, NPS, and the need of care in PWD. The findings highlight the need for preventive interventions and non-medical treatment options in regards to delirium and NPS as well as for a more intensive use of screening tools for inappropriate medication use among PWD. Key points The percentage of new users was 1.8%, 7.1%, 2.1%, and 2.5% across hospitalizations for antidepressants, antipsychotics, anxiolytics or hypnotics/sedatives, and Alzheimer's medication, respectively. 83.0%, 61.9%, 56.9%, and 88.1% of new users received antidepressants, antipsychotics, anxiolytics or hypnotics/sedatives, and Alzheimer's medication for more than 6 weeks. Delirium and neuropsychiatric symptoms were associated with significantly increased odds of new psychotropic medication use. Hospital stays due to dementia and the need of care were predictors for new use of psychotropic medication.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moellers, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Perna, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Stocker, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Ihle, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Schubert, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoettker, Ben UNSPECIFIED UNSPECIFIED UNSPECIFIED Froelich, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED Brenner, Hermann UNSPECIFIED orcid.org/0000-0002-6129-1572 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-332416
DOI:	10.1002/gps.5282
Journal or Publication Title:	Int. J. Geriatr. Psychiatr.
Volume:	35
Number:	6
Page Range:	S. 640 - 650
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1099-1166
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NURSING-HOME RESIDENTS; ALZHEIMERS-DISEASE; NEUROPSYCHIATRIC SYMPTOMS; PSYCHOLOGICAL SYMPTOMS; DRUG-USE; MANAGEMENT; IMPACT; POLYPHARMACY; ASSOCIATION; PREVALENCE Multiple languages Geriatrics & Gerontology; Gerontology; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33241