Antipsychotic utilization in the intensive care unit and in transitions of care

Journal of Critical Care
John MarshallJennifer P Stevens

Abstract

The objective of this study was to quantify the rate at which newly initiated antipsychotic therapy is continued on discharge from the intensive care unit (ICU) and describe risk factors for continuation post-ICU discharge. This is a retrospective cohort study of all patients receiving an antipsychotic in the ICUs of a large academic medical center from January 1, 2005, to October 31, 2011. Medical record review was conducted to ascertain whether a patient was newly started on antipsychotic therapy and whether therapy was continued post-ICU discharge. A total of 39,248 ICU admissions over the 7-year period were evaluated. Of these, 4468 (11%) were exposed to antipsychotic therapy, of which 3119 (8%) were newly initiated. In the newly initiated cohort, 642 (21%) were continued on therapy on discharge from the hospital. Type of drug (use of quetiapine vs no use of quetiapine: odds ratio, 3.2; 95% confidence interval, 2.5-4.0; P < .0001 and use of olanzapine: odds ratio, 2.4, 95% confidence interval, 2.0-3.1; P ≤ .0001) was a significant risk factor for continuing antipsychotics on discharge despite adjustment for clinical factors. Antipsychotic use is common in the ICU setting, and a significant number of newly initiated patients...Continue Reading

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Citations

Oct 4, 2016·Journal of Critical Care·David J GagnonGilles L Fraser
Jun 7, 2017·Journal of Pharmacy Practice·Kevin M DubePaul M Szumita
Mar 12, 2019·Critical Care Medicine·Andrea P TullyRachel M Kruer
Jan 17, 2020·The Mental Health Clinician·Lauren HalavonichBailey Bass
Jul 24, 2020·The Annals of Pharmacotherapy·Kelsey L OhmanBridgette L Kram
Aug 5, 2020·The Annals of Pharmacotherapy·Nicholas J QuinnHeather Torbic
Nov 25, 2016·Critical Care : the Official Journal of the Critical Care Forum·Jason E TomichekTimothy D Girard
Sep 22, 2018·Critical Care : the Official Journal of the Critical Care Forum·Kunal KaramchandaniZyad J Carr
Jun 20, 2020·Journal of Intensive Care Medicine·Emily J WitcraftLeah S Millstein
Jan 19, 2021·Journal of the American Medical Directors Association·Anna HakalaMiia Tiihonen
Apr 26, 2021·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Deepali DixitMaria Cardinale
Aug 7, 2021·Clinics in Chest Medicine·Tasnim I LatHeath D White

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Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

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