Ari Jaffe1, Jerome Levine, Leslie Citrome. 1. Nathan S Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
Abstract
OBJECTIVE: This study describes the use of "stat" medications for inpatients in a large state psychiatric hospital system, and examines the relationship between receipt of a "stat" for agitation and subsequent hospital discharge. METHODS: Use of "stat" medications in 2005 was retrospectively determined using a database that contains diagnosis and prescription information from 17 state-run adult civil facilities. A logistic regression model explored the relationship between receipt of a "stat" order for intramuscular preparations of either antipsychotics or lorazepam within the first 30 days of hospitalization and likelihood of hospital discharge by 6 months. RESULTS: Among 7,202 patients who received antipsychotic medication in 2005, 3,240 (45%) also received a "stat" psychotropic medication during that year. Among 40,651 stat orders, 19,142 (47%) were for intramuscular antipsychotics or lorazepam presumably given for the treatment of agitation. Among 1,673 patients admitted in the first 6 months of 2005, 415 (25%) received at least one such "agitation stat." The percent discharged at six months among "agitation stat" receivers was 39%, compared to 69% among those who did not receive an "agitation stat" (chi-square = 115, df = 1, P < .001). Regression analysis showed that receiving an "agitation stat" in the first 30 days of hospitalization was associated with a 37% lower likelihood of being discharged by 6 months after admission (odds ratio .63, 95% CI: .46-.86). CONCLUSIONS: "Stat" medications are commonly used. The use of "agitation stat" medications can be used as a proxy for clinical stability and may prove to be a useful outcome measure for future pharmacoepidemiologic studies of comparative medication effectiveness.
OBJECTIVE: This study describes the use of "stat" medications for inpatients in a large state psychiatric hospital system, and examines the relationship between receipt of a "stat" for agitation and subsequent hospital discharge. METHODS: Use of "stat" medications in 2005 was retrospectively determined using a database that contains diagnosis and prescription information from 17 state-run adult civil facilities. A logistic regression model explored the relationship between receipt of a "stat" order for intramuscular preparations of either antipsychotics or lorazepam within the first 30 days of hospitalization and likelihood of hospital discharge by 6 months. RESULTS: Among 7,202 patients who received antipsychotic medication in 2005, 3,240 (45%) also received a "stat" psychotropic medication during that year. Among 40,651 stat orders, 19,142 (47%) were for intramuscular antipsychotics or lorazepam presumably given for the treatment of agitation. Among 1,673 patients admitted in the first 6 months of 2005, 415 (25%) received at least one such "agitation stat." The percent discharged at six months among "agitation stat" receivers was 39%, compared to 69% among those who did not receive an "agitation stat" (chi-square = 115, df = 1, P < .001). Regression analysis showed that receiving an "agitation stat" in the first 30 days of hospitalization was associated with a 37% lower likelihood of being discharged by 6 months after admission (odds ratio .63, 95% CI: .46-.86). CONCLUSIONS: "Stat" medications are commonly used. The use of "agitation stat" medications can be used as a proxy for clinical stability and may prove to be a useful outcome measure for future pharmacoepidemiologic studies of comparative medication effectiveness.
Authors: Maria Rubio-Valera; Juan V Luciano; José Miguel Ortiz; Luis Salvador-Carulla; Alfredo Gracia; Antoni Serrano-Blanco Journal: BMC Psychiatry Date: 2015-03-04 Impact factor: 3.630