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Updated: Jun 28, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Central nervous system medication use around hospitalization.

Juliessa M Pavon^1,2,3,4, Richard J Sloane^2,3,4, Cathleen S Colón-Emeric^1,2,3,4

¹Department of Medicine/Division of Geriatrics, Duke University, Durham, North Carolina, USA.

Journal of the American Geriatrics Society

|April 11, 2024

Summary

Central nervous system (CNS) medication use remains stable for most older adults during hospitalization. However, some patients, particularly those on pain medications, may discontinue CNS drugs between admission and discharge.

Keywords:

central nervous system medications deprescribing electronic health records hospital older adults

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Area of Science:

Geriatric Pharmacology
Health Services Research
Clinical Pharmacy

Background:

Central nervous system (CNS) medication use is prevalent in older adults.
The impact of hospitalizations on CNS medication regimens is not well understood.
This study investigates CNS medication use patterns and user profiles during hospital stays.

Purpose of the Study:

To analyze CNS medication use, discontinuations, and user profiles in older adults around hospitalization.
To identify distinct patient profiles based on CNS medication use across different time points.
To examine factors influencing transitions between CNS medication use profiles during hospitalization.

Main Methods:

Retrospective cohort study of patients aged 65 years and older using electronic health records (2018-2020).
Analysis of CNS medication use from 90 days prior to 90 days after hospitalization.
Latent class transitions analysis (LCTA) to identify user profiles and transitions across four time points.

Main Results:

Antidepressants (56%) and opioids (49%) were the most common CNS medications prescribed.
74% of patients were persistent users; 7% discontinued CNS medications during hospitalization, with 64% restarting within 90 days post-discharge.
Three main user profiles were identified: low CNS users (54-60%), mental health users (30-36%), and pain medication users (9-10%).
Discontinuation was more likely between admission and discharge, especially for pain medication users (9% probability).
Female gender increased odds, while chronic kidney disease decreased odds of transitioning to low CNS use between admission and discharge.

Conclusions:

CNS medication use generally remains consistent for older adults around hospitalizations.
Discontinuation of CNS medications is more probable during the admission-to-discharge period, particularly for pain medication users.
Further research is warranted to assess the outcomes of hospital deprescribing, especially for medications needing gradual tapering.