Psychotropic medication changes, polypharmacy, and the risk of early readmission in suicidal adolescent inpatients

The Annals of Pharmacotherapy
Cynthia A FontanellaJohn V Campo

Abstract

Adolescents with acute suicidal ideation and attempts are frequently treated with psychotropic medications in psychiatric hospitals. However, little is known about whether pharmacologic interventions used to stabilize suicidal adolescents within inpatient settings are effective in reducing early readmission. To examine whether psychotropic medication changes and polypharmacy are associated with 30-day readmission rates for suicidal adolescents. We conducted a retrospective cohort study of 318 Medicaid-enrolled adolescents admitted for suicidal behaviors to 3 major inpatient psychiatric hospitals in Maryland. Comprehensive data on patient demographics, clinical factors, service history, and inpatient treatment practices were collected from hospital medical records. Medications prescribed prior to admission and during the hospital stay were matched and compared with regard to drug, dosage, and frequency of administration to identify the different types of medication changes. Multivariate Cox proportional hazard analysis was used to examine the association of medication changes and polypharmacy with readmission. At least one medication change was made in 78% of suicidal adolescent inpatients, typically the addition of an antidepre...Continue Reading

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