Does being assisted by care workers affect antipsychotics prescription among older people discharged from hospital?

Geriatr Gerontol Int. 2017 Oct;17(10):1707-1713. doi: 10.1111/ggi.12931. Epub 2016 Nov 10.

Abstract

Aim: Several factors can affect antipsychotic prescriptions, among which, caregivers. However, whether being assisted by a care worker might increase the rate of antipsychotic prescriptions at discharge from acute care hospital has not been previously investigated. We aimed to investigate whether being assisted by a care worker is associated with increased use of antipsychotics among older patients discharged from acute care hospitals.

Methods: The present series consisted of 928 patients not taking antipsychotics at admission in seven acute care wards of geriatric medicine in Italy (mean age 80.8 ± 7.2 years, 54.9% women). The outcome of the study was defined as receiving an antipsychotic prescription at discharge. Patients were grouped according to their living conditions as follows: (i) living alone; (ii) living only with care worker; (iii) living with care worker and family members; and (iv) living only with family members. The association between study variables and antipsychotic prescription at discharge was investigated by logistic regression analysis.

Results: After adjusting for potential confounders, being assisted by care workers was significantly associated with the outcome (OR 2.64, 95% CI 1.21-5.75). Diagnosis of dementia (OR 2.73, 95% CI 1.65-4.51), instrumental activities of daily living limitations (OR 1.12, 95% CI 1.05-1.21) and delirium during stay (OR 3.87, 95% CI 2.01-7.47) also qualified as independent correlates of antipsychotic prescription at discharge.

Conclusions: Being assisted by care workers could increase the likelihood of receiving antipsychotics at discharge from acute care hospitals. Geriatr Gerontol Int 2017; 17: 1707-1713.

Keywords: Italy; antipsychotics; care workers; hospital Discharge.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use*
  • Caregivers*
  • Delirium / diagnosis
  • Delirium / drug therapy
  • Dementia / diagnosis
  • Dementia / drug therapy
  • Female
  • Humans
  • Italy
  • Male
  • Patient Discharge*
  • Residence Characteristics*

Substances

  • Antipsychotic Agents