Antipsychotic prescribing and drug-related readmissions in multimorbid older inpatients, a post-hoc analysis of the OPERAM population.

Antipsychotic prescribing and drug-related readmissions in multimorbid older inpatients, a post-hoc analysis of the OPERAM population. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Antipsychotic prescribing and drug-related readmissions in multimorbid older inpatients, a post-hoc analysis of the OPERAM population. Adeline Bienfait, Juliette Lagreula, Manuel R. Blum, Nicolas Rodondi, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3268091/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Feb, 2024 Read the published version in International Journal of Clinical Pharmacy → Version 1 posted 6 You are reading this latest preprint version Abstract Background. Limited data are available on characteristics associated with antipsychotic’s use in multimorbid older adults. Aims. (1) To identify factors associated with antipsychotic prescribing in older inpatients, (2) to assess the association between antipsychotic use and drug-related readmission (DRA) within one year. Method. This is a secondary analysis of the OPERAM randomized controlled trial which evaluated the impact of a structured medication review on DRA in multimorbid polymedicated inpatients aged ³70. Multivariate analysis assessed the association between characteristics and comorbidities (including neuro-psychiatric conditions), with antipsychotic use. An expert team assessed DRA occurring during the one-year follow-up. Results. Antipsychotics were prescribed to 110/2008 patients upon admission while 7,7% (n=154) inpatients received antipsychotics at any time (i.e. upon admission, during hospitalisation, and/or at discharge). The most frequently prescribed antipsychotics were quetiapine (n=152), haloperidol (n= 48) and risperidone (n=22), used at low dose (mean PDD/DDD ratio= 0,37). Antipsychotic prescribing was associated with dementia (OR=3,7 95%CI[2,2;6,2]), psychosis (OR=26,2 [7,4;92,8]), delirium (OR=6,4 [3,8;10,8]), mood disorders (OR=2,6 [1,6;4,1]), ≥15 drugs a day (OR=1,7 [1,4;3,6]), functional dependency (Activities of Daily Living score <50/100) (OR=3,9 [2,5;6,1]) and < 2 units of alcohol per week (OR=2,2 [1,4;3,6]). DRA occurred in 458 patients (22.8%) within one year. Antipsychotic prescribing was not associated with DRA (OR=1,0 [0,3;3,9]) however contributed to 8 DRAs, including 3 falls. Conclusion: In this European multimorbid polymedicated older inpatients, antipsychotics were unfrequently prescribed, most often at low dosage. Besides neuro-psychiatric symptoms, risk factors for inhospital antipsychotic prescribing were lower functional status and polymedication. Figures Figure 1 Figure 2 Full Text Additional Declarations Tables 1-3 is available in the Supplementary Files section. Supplementary Files Tables.pdf Cite Share Download PDF Status: Published Journal Publication published 17 Feb, 2024 Read the published version in International Journal of Clinical Pharmacy → Version 1 posted Editorial decision: Major revisions 04 Nov, 2023 Reviewers agreed at journal 20 Aug, 2023 Reviewers invited by journal 17 Aug, 2023 Editor invited by journal 16 Aug, 2023 Editor assigned by journal 16 Aug, 2023 First submitted to journal 15 Aug, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3268091","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":226964284,"identity":"8b62eb53-b8f0-4f9b-80aa-225c7ffd6329","order_by":0,"name":"Adeline Bienfait","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIie3PoQrCUBTG8XMZHMvUqgjuFe4QTIqvMhksaTcqg2PRPpNvoUbHQMseQFjRsiiziIKC9y6K3Gkz3H874cfHAdDp/rIBbAGagGDs8htLANkXpAWI6AE4ghjAgiICkgCa7ZxAEalOh+H2suFWxZpdj5fbyqoI4o8UpBafnXARc5uwvLYDJ7FJkEmsmjkMeFSmBxNk1TCdhAlSOo0VwpLkSbxHaKaS9PIVFeGSMOJ9QVCSfiGx5S9z4i6h164HXuKSwSZK0twPo+xOvLv0o7SWdZLucuqHSvIp9ivQ6XQ63XsvqUtNxBypBBUAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-5079-5230","institution":"Université catholique de Louvain: Universite Catholique de Louvain UCLouvain","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Adeline","middleName":"","lastName":"Bienfait","suffix":""},{"id":226964285,"identity":"7429203b-93ca-44ee-beb0-c5b5cea5c18f","order_by":1,"name":"Juliette Lagreula","email":"","orcid":"","institution":"Université catholique de Louvain: Universite Catholique de Louvain UCLouvain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Juliette","middleName":"","lastName":"Lagreula","suffix":""},{"id":226964286,"identity":"7231cb82-ef99-498a-8bce-1334d034039f","order_by":2,"name":"Manuel R. 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RA= related readmission\u003c/p\u003e","description":"","filename":"F1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3268091/v1/371383e59fc04d1cf447d4d0.jpg"},{"id":41960718,"identity":"6a18b20a-ed77-488d-b4f3-85737f83b0ed","added_by":"auto","created_at":"2023-08-22 21:16:29","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":180173,"visible":true,"origin":"","legend":"\u003cp\u003ePrescribed antipsychotics at any time during index hospitalisation ((i.e. upon admission, during hospitalisation, and/or at discharge among the 2008 OPERAM patients.\u003c/p\u003e","description":"","filename":"F2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3268091/v1/dd675c62f4cb3e469c8466bc.jpg"},{"id":51322759,"identity":"b6137613-74dd-49ec-a8e2-3a57210f97c6","added_by":"auto","created_at":"2024-02-19 15:10:53","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":527566,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3268091/v1_covered_b45cd73c-99c2-45ae-b5cd-1ddac5b79ae9.pdf"},{"id":41960717,"identity":"15063f24-3ab3-4910-9441-a9eece6e2d2d","added_by":"auto","created_at":"2023-08-22 21:16:29","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":764883,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3268091/v1/60aec3703bd25e9dad8bdf19.pdf"}],"financialInterests":"\u003cp\u003eTables 1-3 is available in the Supplementary Files section.\u003c/p\u003e","formattedTitle":"Antipsychotic prescribing and drug-related readmissions in multimorbid older inpatients, a post-hoc analysis of the OPERAM population.","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3268091/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3268091/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground.\u003c/strong\u003e\u0026nbsp;Limited data are available on characteristics associated with antipsychotic’s use in multimorbid older adults.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAims.\u003c/strong\u003e (1) To identify factors associated with antipsychotic prescribing in older inpatients, (2) to assess the association between antipsychotic use and drug-related readmission (DRA) within one year.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod.\u0026nbsp;\u003c/strong\u003eThis is a\u0026nbsp;secondary\u0026nbsp;analysis of the OPERAM randomized controlled trial which evaluated\u0026nbsp;the impact of a structured medication review on DRA\u0026nbsp;in multimorbid polymedicated inpatients aged\u0026nbsp;³70. Multivariate analysis assessed the association between characteristics and comorbidities (including neuro-psychiatric conditions), with antipsychotic use. An expert team assessed DRA\u0026nbsp;occurring during the one-year follow-up.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults.\u0026nbsp;\u003c/strong\u003eAntipsychotics were prescribed to 110/2008 patients upon admission while 7,7% (n=154) inpatients received antipsychotics at any time (i.e. upon admission, during hospitalisation, and/or at discharge).\u0026nbsp;The most frequently prescribed antipsychotics were quetiapine (n=152), haloperidol (n= 48) and risperidone (n=22),\u0026nbsp;used at low dose (mean PDD/DDD ratio= 0,37). Antipsychotic prescribing was associated with dementia\u0026nbsp;(OR=3,7 95%CI[2,2;6,2]),\u0026nbsp;psychosis\u0026nbsp;(OR=26,2\u0026nbsp;[7,4;92,8]),\u0026nbsp;delirium\u0026nbsp;(OR=6,4 [3,8;10,8]), mood disorders\u0026nbsp;(OR=2,6\u0026nbsp;[1,6;4,1]), \u0026nbsp;≥15 drugs a day (OR=1,7\u0026nbsp;[1,4;3,6]), functional dependency (Activities of Daily Living score \u0026lt;50/100)\u0026nbsp;(OR=3,9\u0026nbsp;[2,5;6,1])\u0026nbsp;and \u0026lt; 2 units of alcohol per week\u0026nbsp; (OR=2,2\u0026nbsp;[1,4;3,6]). DRA occurred in 458 patients (22.8%) within one year. Antipsychotic\u0026nbsp;prescribing\u0026nbsp;was not associated with DRA (OR=1,0\u0026nbsp;[0,3;3,9]) however contributed to 8 DRAs, including 3\u0026nbsp;falls.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u0026nbsp;\u003c/strong\u003eIn this European multimorbid\u0026nbsp;polymedicated\u0026nbsp;older inpatients, antipsychotics were unfrequently prescribed, most often at low dosage. Besides neuro-psychiatric symptoms, risk factors for inhospital antipsychotic prescribing were lower functional status and polymedication.\u003c/p\u003e","manuscriptTitle":"Antipsychotic prescribing and drug-related readmissions in multimorbid older inpatients, a post-hoc analysis of the OPERAM population.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-08-22 21:16:25","doi":"10.21203/rs.3.rs-3268091/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revisions","date":"2023-11-04T09:45:27+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2023-08-20T06:31:12+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-08-17T05:41:16+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"International Journal of Clinical Pharmacy","date":"2023-08-16T17:07:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-08-16T12:40:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Clinical Pharmacy","date":"2023-08-16T03:59:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"30f516d3-5037-4dae-9ff6-1238a4e94cf5","owner":[],"postedDate":"August 22nd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-02-19T15:02:47+00:00","versionOfRecord":{"articleIdentity":"rs-3268091","link":"https://doi.org/10.1007/s11096-024-01700-6","journal":{"identity":"international-journal-of-clinical-pharmacy","isVorOnly":false,"title":"International Journal of Clinical Pharmacy"},"publishedOn":"2024-02-17 15:00:44","publishedOnDateReadable":"February 17th, 2024"},"versionCreatedAt":"2023-08-22 21:16:25","video":"","vorDoi":"10.1007/s11096-024-01700-6","vorDoiUrl":"https://doi.org/10.1007/s11096-024-01700-6","workflowStages":[]},"version":"v1","identity":"rs-3268091","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3268091","identity":"rs-3268091","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}