{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:52:31Z","timestamp":1777589551850,"version":"3.51.4"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: In older adults, the use of antipsychotics to treat delirium or the behavioural and psychological symptoms of dementia is potentially inappropriate and may be associated with adverse effects. Antipsychotics newly initiated in hospital may be inadvertently continued after discharge. In the Saskatchewan Health Authority (SHA) \u2013 Regina area, the frequency and duration of antipsychotic continuation for older adults after initiation during a hospital stay is unknown.\nObjectives: To describe potentially inappropriate antipsychotic use in older adults after discharge from hospital, specifically rates of postdischarge antipsychotic therapy after initiation in hospital and continuation up to 180 days after discharge; prescribing regimens used; risk factors associated with continuation; pharmacist involvement; and plans for antipsychotic discontinuation, tapering, and\/or follow-up.\nMethods: This retrospective chart review included inpatients 65 years of age or older who were discharged from medicine units at SHA \u2013 Regina area hospitals between September 30, 2021, and June 28, 2022. Outpatient dispensing histories were also gathered.\nResults: Of the 189 patients included in the analysis, 60 (31.7%) had continuation of antipsychotic therapy at discharge. Of these, 48 (80.0%), 33 (55.0%), and 24 (40.0%) had continuation of antipsychotic therapy at 30, 90, and 180 days after discharge, respectively. Of the patients with continuing antipsychotic therapy, 53 (88.3%) were 75 years of age or older, and 9 (15.0%) had documentation of an outpatient antipsychotic follow-up plan.\nConclusions: Postdischarge continuation of antipsychotics was similar to that reported in the literature. Patients continued on antipsychotics after discharge were at a greater than 50% risk of continuation at 90 days and were unlikely to have a follow-up plan. Future quality improvement efforts should include standardized prioritization of medication reviews, documentation of indications, and regular reassessment of therapy.\nKeywords: antipsychotics, older adults, delirium, dementia, behavioural and psychological symptoms of dementia, prescribing\nR\u00c9SUM\u00c9\nContexte : Chez les personnes \u00e2g\u00e9es, l\u2019utilisation d\u2019antipsychotiques pour traiter le d\u00e9lire ou les sympt\u00f4mes comportementaux et psychologiques de la d\u00e9mence est potentiellement inappropri\u00e9e et associ\u00e9e \u00e0 des effets ind\u00e9sirables. Le traitement antipsychotique initi\u00e9 \u00e0 l\u2019h\u00f4pital pourrait se poursuivre par inadvertance apr\u00e8s le cong\u00e9. Dans la r\u00e9gion de Regina de la Saskatchewan Health Authority (SHA), la fr\u00e9quence et la dur\u00e9e du maintien d\u2019antipsychotiques chez les personnes \u00e2g\u00e9es apr\u00e8s l\u2019initiation au cours d\u2019un s\u00e9jour \u00e0 l\u2019h\u00f4pital sont inconnues.\nObjectifs : D\u00e9crire l\u2019utilisation potentiellement inappropri\u00e9e d\u2019antipsychotiques chez les personnes \u00e2g\u00e9es apr\u00e8s le cong\u00e9 de l\u2019h\u00f4pital, en particulier les taux de traitement antipsychotique initi\u00e9 \u00e0 l\u2019h\u00f4pital qui continue apr\u00e8s le cong\u00e9 et son maintien jusqu\u2019\u00e0 180 jours apr\u00e8s le cong\u00e9; les sch\u00e9mas de prescription utilis\u00e9s; les facteurs de risque associ\u00e9s au maintien; l\u2019implication du pharmacien; et les plans visant \u00e0 arr\u00eater, r\u00e9duire progressivement et\/ou \u00e0 faire le suivi de la prise d\u2019antipsychotiques.\nM\u00e9thodologie : Cet examen r\u00e9trospectif des dossiers comprenait des patients hospitalis\u00e9s \u00e2g\u00e9s d\u2019au moins 65 ans qui \u00e9taient sortis des unit\u00e9s de m\u00e9decine d\u2019h\u00f4pitaux de la r\u00e9gion de Regina de la SHA entre le 30 septembre 2021 et le 28 juin 2022. Les historiques de d\u00e9livrance en ambulatoire ont \u00e9galement \u00e9t\u00e9 recueillis.\nR\u00e9sultats : Sur les 189 patients inclus dans l\u2019analyse, 60 (31,7 %) ont continu\u00e9 leur traitement antipsychotique au moment du cong\u00e9. Parmi eux, 48 (80,0 %), 33 (55,0 %) et 24 (40,0 %) continuaient leur traitement antipsychotique \u00e0 30, 90 et 180 jours apr\u00e8s leur cong\u00e9, respectivement. Parmi les patients recevant un traitement antipsychotique continu, 53 (88,3 %) \u00e9taient \u00e2g\u00e9s d\u2019au moins 75 ans et 9 (15,0 %) avaient un plan de suivi antipsychotique ambulatoire.\nConclusions : Le maintien des antipsychotiques apr\u00e8s le cong\u00e9 \u00e9tait similaire \u00e0 celui rapport\u00e9 dans la litt\u00e9rature. Les patients qui continuaient \u00e0 prendre des antipsychotiques apr\u00e8s leur cong\u00e9 couraient un risque sup\u00e9rieur \u00e0 50 % de continuer \u00e0 90 jours et \u00e9taient peu susceptibles de disposer d\u2019un plan de suivi. Les futurs efforts d\u2019am\u00e9lioration de la qualit\u00e9 devraient comprendre une priorisation standardis\u00e9e des examens des m\u00e9dicaments, la documentation des indications et une r\u00e9\u00e9valuation r\u00e9guli\u00e8re du traitement.\nMots-cl\u00e9s: antipsychotiques, personnes \u00e2g\u00e9es, d\u00e9lire, d\u00e9mence, sympt\u00f4mes comportementaux et psychologiques de la d\u00e9mence, prescription<\/jats:p>","DOI":"10.4212\/cjhp.3543","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T13:38:35Z","timestamp":1715693915000},"source":"Crossref","is-referenced-by-count":1,"title":["Antipsychotic Prescribing in Older Adults after In-Hospital Initiation"],"prefix":"10.4212","volume":"77","author":[{"given":"Jillian","family":"Madey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Tri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleina","family":"Haines","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Zimmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn","family":"Halpape","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zack","family":"Dumont","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2024,5,8]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3543\/5302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3543\/5303","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3543\/5302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T13:38:44Z","timestamp":1715693924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,8]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,4,10]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3543","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2024,5,8]]},"article-number":"e3543"}}