Article

OBJECTIVE: To describe psychotropic medication administration patterns during
inpatient rehabilitation for traumatic brain injury (TBI) and their relation to
patient preinjury and injury characteristics. DESIGN: Prospective observational
cohort. SETTING: Multiple acute inpatient rehabilitation units or hospitals.
PARTICIPANTS: Individuals with TBI (N=2130; complicated mild, moderate, or
severe) admitted for inpatient rehabilitation. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Not applicable. RESULTS: Most frequently administered were
narcotic analgesics (72% of sample), followed by antidepressants (67%),
anticonvulsants (47%), anxiolytics (33%), hypnotics (30%), stimulants (28%),
antipsychotics (25%), antiparkinson agents (25%), and miscellaneous psychotropics
(18%). The psychotropic agents studied were administered to 95% of the sample,
with 8.5% receiving only 1 and 31.8% receiving >/=6. Degree of psychotropic
medication administration varied widely between sites. Univariate analyses
indicated younger patients were more likely to receive anxiolytics,
antidepressants, antiparkinson agents, stimulants, antipsychotics, and narcotic
analgesics, whereas those older were more likely to receive anticonvulsants and
miscellaneous psychotropics. Men were more likely to receive antipsychotics. All medication classes were less likely administered to Asians and more likely
administered to those with more severe functional impairment. Use of
anticonvulsants was associated with having seizures at some point during acute
care or rehabilitation stays. Narcotic analgesics were more likely for those with
history of drug abuse, history of anxiety and depression (premorbid or during
acute care), and severe pain during rehabilitation. Psychotropic medication
administration increased rather than decreased during the course of inpatient
rehabilitation in each of the medication categories except for narcotics. This
observation was also true for medication administration within admission
functional levels (defined by cognitive FIM scores), except for those with higher
admission FIM cognitive scores. CONCLUSIONS: Many psychotropic medications are
used during inpatient rehabilitation. In general, lower admission FIM cognitive
score groups were administered more of the medications under investigation
compared with those with higher cognitive function at admission. Considerable
site variation existed regarding medications administered. The current
investigation provides baseline data for future studies of effectiveness.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS