{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:02:19Z","timestamp":1780448539848,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small studies have reported associations between first\u2010generation antihistamines and delirium. It is unclear whether first\u2010generation antihistamines cause clinically important delirium among older adult inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the association between inpatient physician prescribing of first\u2010generation antihistamines and delirium among older general medicine inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross\u2010sectional study using the GEMINI database of inpatient admissions between April 1, 2015, and March 31, 2022, across 17 hospitals in Ontario, Canada, among people aged 65\u2009years and older. The main exposure was the proportion of attending physicians' admissions by quartile that included a first\u2010generation antihistamine prescription. The primary outcome was inpatient delirium identified using a machine learning tool. We estimated the association between attending physicians' first\u2010generation antihistamine prescribing rate and individual inpatients' risk of delirium using multivariable mixed\u2010effects logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 328,140 inpatient admissions to 755 physicians, 11,507 (3.5%) admissions included a first\u2010generation antihistamine prescription. Physicians in the lowest quartile prescribed a first\u2010generation antihistamine during 2.1% of admissions compared to 5.4% of physicians in the highest quartile. Delirium occurred in 32.3% of admissions to the lowest\u2010prescribing quartile and 36.6% of the highest\u2010prescribing quartile of physicians. In adjusted analyses, every 1% absolute increase in first\u2010generation antihistamine prescribing was associated with 8% increased odds of delirium (aOR: 1.08, 95% CI: 1.05\u20131.10). Patients admitted to physicians in the highest quartile had 41% increased odds of delirium compared to the lowest quartile (aOR: 1.41, 95% CI: 1.28\u20131.56).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older adults admitted to physicians who prescribe first\u2010generation antihistamines more commonly were more likely to experience delirium in the hospital.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70121","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:01:13Z","timestamp":1761116473000},"page":"3475-3483","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Inpatient Prescribing of First\u2010Generation Antihistamines With Delirium in Older Adults: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-1527","authenticated-orcid":false,"given":"Alanna C.","family":"Bridgman","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine Women's College Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Arshad","family":"Imrit","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surain B.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2082-2445","authenticated-orcid":false,"given":"Michael","family":"Fralick","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine and Geriatrics Sinai Health, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-6013","authenticated-orcid":false,"given":"Jennifer","family":"Watt","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute St. Michael's Hospital, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"},{"name":"Unity Health, University of Toronto  Toronto Ontario 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