Related Experiment Video
Updated: May 21, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Drug utilization in geriatric psychiatric patients in the emergency department-a cohort study under real-world
Martin Schulze Westhoff1, Sophie Bannasch2, Johannes Heck3
1Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
Background:
Psychiatric emergencies include agitation, substance-related (e.g., withdrawal) symptoms, and suicidal as well as self-harming behavior and require interdisciplinary management. Drug treatment of geriatric patients in emergency situations may be complicated by adverse drug reactions (ADRs).
Objectives:
This study aimed to investigate prescriptions of potentially inappropriate medications (PIMs) and potential drug-drug interactions (DDIs) in the context of geriatric psychiatric emergencies in the emergency department (ED).
Design:
Retrospective single-center study.
Methods:
The medication lists of 87 consecutively acquired geriatric patient cases receiving pharmacological treatment between January 2018 and December 2022 in a psychiatric emergency department were analyzed. Herein, utilizing the PRISCUS 2.0 list and the Fit fOR The Aged (FORTA) classification, prescriptions of PIMs were assessed, and DDIs were classified with the aid of the drug interaction program AiDKlinik® (Arzneimittel-Informations-Dienste, Dosing GmbH, Heidelberg, Germany).
Results:
A total of 94 drugs were administered during treatment in the ED. The total number of drugs per patient was on average 5.9 1 (median: 5; interquartile range: 4) hereafter. 77.7% of the newly prescribed drugs were PIMs according to the PRISCUS 2.0 list, while 18.1% were designated as therapeutic alternatives to PIMs. 70.2% and 22.3% of the newly recommended drugs were FORTA category C and D drugs, respectively. An average of 0.8 (median: 0; interquartile range: 1) potential DDIs existed before psychiatric ED treatment, and 0.9 (median: 0; interquartile range: 2) potential DDIs thereafter (p = 0.002). Coercive measures-such as administration of medication against the patient's will-were rarely required in the study population.
Conclusion:
The majority of all drug prescriptions for the treatment of geriatric psychiatric emergencies were categorized as PIMs according to the PRISCUS 2.0 list and the FORTA classification. However, it should be noted that these PIM classification systems were not specifically designed for geriatric psychiatric settings. The number of potential DDIs was significantly higher after drug administration in the ED than before, which should prompt the monitoring of certain clinical parameters in the further course of treatment.
More Related Videos
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
06:59A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Related Concept Videos
01:28Drug Therapy
Antianxiety Medications
01:26Psychosis: Goals of Pharmacotherapy
01:21Factors Affecting Drug Response: Overview
01:28Psychosis and Antipsychotic Drugs: Overview
01:23Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...