Evaluation of Neuroleptic Utilization in the Intensive Care Unit During Transitions of Care

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Abstract

Purpose:

The purpose of this study was to identify risk factors associated with inappropriate continuation of neuroleptics postdischarge from the intensive care unit (ICU) and hospital.

Materials and Methods:

A retrospective chart review was performed including all patients greater than 18 years of age who received neuroleptic medications in an ICU.

Results:

One hundred sixty-one patients were included during the 12- month study period. There were 85 (53%) patients discharged from the ICU with inappropriate continuation of a neuroleptic medication. There were 54 (34%) patients discharged from the hospital with inappropriate continuation of a neuroleptic medication. Patients were more likely to be discharged from the ICU with an inappropriate neuroleptic if they were prescribed multiple neuroleptics (P = .02), did not have a urine drug screen collected at admission (P = .023), or if trazodone was utilized in their therapy (P = .004). Patients were more likely to be discharged from the hospital with a neuroleptic if they had multiple neuroleptic orders (P = .0001) or if trazodone was utilized in their therapy (P = .0023).

Conclusion:

Risk factors associated with the continuation of inappropriate neuroleptic medications upon discharge from the ICU or the hospital include multiple neuroleptic medications prescribed, the lack of a urine drug screen upon admission, and the utilization of trazodone.

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