Discontinuation of somatic medication during psychiatric hospitalization

Ann Pharmacother. 2014 Nov;48(11):1415-24. doi: 10.1177/1060028014544897. Epub 2014 Jul 30.

Abstract

Background: Psychiatric hospitalization can increase the risk of discontinuation of pharmacotherapy, which may negatively influence patients' health.

Objective: To investigate the association between psychiatric hospitalization and discontinuation of somatic medication.

Methods: A retrospective crossover study was performed in patients admitted to a psychiatric hospital (index date), who had got somatic medication dispensed during the 3 months prior to hospitalization. Discontinuation of somatic medication was investigated at the following time points: index date and 3, 6, and 9 months before the index date. Relative risks (RR) with 95% confidence intervals (95% CIs) of discontinuing somatic medication at the index date versus the time points before the index date were estimated using Cox regression.

Results: In all, 471 hospitalized patients were included in the study; 38.9% of the patients were discontinuers on the index date. RR for discontinuation of ≥1 somatic medication was 1.88 (95% CI=1.55-2.27) at the index date compared with the other time points and highest for patients<45 years (RR=2.83; 95% CI=1.92-4.18).

Conclusions: Psychiatric hospitalization was associated with an almost doubled risk of discontinuation of somatic medication. Future studies should address the influence of discontinuation of care on patients' health.

Keywords: continuation of care; discontinuation; psychiatric hospital; psychiatry; somatic medication.

MeSH terms

  • Adult
  • Aged
  • Continuity of Patient Care*
  • Cross-Over Studies
  • Drug Therapy*
  • Female
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Retrospective Studies
  • Risk