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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 1 of 1 Research Studies DisplayedGrowdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization