Pharmacist intervention lessens inappropriate antipsychotic use upon discharge

A pharmacist-driven intervention contributes to a reduction in inappropriate continuations of antipsychotic medications following intensive care unit (ICU) discharge, a study has shown.

Such a decrease was noted at 72 h after patients left the ICU and upon hospital discharge, according to the researchers.

Adult patients who were ordered a formulary antipsychotic for delirium, agitation, or sedation during their ICU-level of care admission were included in this standard-of-care, prospective with historical control study.

The research team designed, implemented, and analysed the benefit of a pharmacist-driven intervention on inappropriate antipsychotic continuation from the ICU to another point in care at a small community hospital.

Of the eligible patients, 33 were in the historical period and 24 in the intervention period. Participants in the intervention period were less likely to continue using antipsychotics beyond 72 h than those in the historical period (16.7 percent vs 57.6 percent; p=0.002).

Similarly, patients in the intervention period had lower odds of continuing antipsychotic use when discharged to home (12.5 percent vs 36.4 percent; p=0.04).

Transitions of care (TOC) are necessary to best practices because “they are at times prone to medication errors,” according to the researchers.

“The ICU is an essential location needing effective TOC due to many reasons, but an important one being that certain medications are only indicated there,” they said. “One example is antipsychotics used for agitation, delirium, and sedation.”