Epidemiology of psychiatric medication use in patients recovering from critical illness at a long-term acute-care facility

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23 Scopus citations

Abstract

Study objectives: To describe the pharmacoepidemiology of psychotropic medication prescription in patients recovering from life-threatening medical and surgical illness. Design: Retrospective analysis of a random sample of medical records. Setting: Regional referral center. Patients: Eighty-nine randomly selected patients transferred from an ICU to the study facility. Interventions: None. Measurements and results: Patients had been treated at the referring ICU for 33 ± 24 days (mean ± SD) and remained at the study hospital for 64 ± 52 days. Most of the patients had prolonged respiratory failure. Nearly half of the patients (47%) received an antidepressant medication while at the facility, and 48% received at least one dose of a benzodiazepine on the first day after transfer. In the sample of 75 patients not prescribed an antidepressant before transfer, 37% were started on therapy with an agent, usually within 3 weeks and predominantly in the selective serotonin reuptake inhibitor or psychostimulant class. Younger patients and those evaluated by a mental health specialist were more likely to be prescribed an antidepressant, compared to other patients. Forty percent of patients were still receiving at least one dose of a benzodiazepine in a 24-h period after their third week at the facility. Conclusion: Although the efficacy of antidepressant pharmacotherapy in patients with comparable severity of medical illness has not been established, a substantial proportion of patients recovering from critical illness at a specialized facility are prescribed antidepressant medications. Benzodiazepine exposure is frequent after transfer, and the prevalence in patients who remain at the facility minimally decreases over time.

Original languageEnglish (US)
Pages (from-to)547-553
Number of pages7
JournalCHEST
Volume119
Issue number2
DOIs
StatePublished - 2001

Keywords

  • Antidepressants
  • Benzodiazepines
  • Critical illness
  • Mechanical ventilation
  • Pharmacoepidemiology

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