Patterson SM, Cadogan CA, Kerse N, Cardwell CR, Bradley MC, Ryan C, Hughes C. Interventions to improve the appropriate use of polypharmacy for older ...
PSYCHOTROPIC MEDICATION RECONCILIATION: CONSIDERING ORTHOGERIATRIC UNIT ADMISSION A CHANCE OF THERAPEUTIC SWITCH
González Ramírez A.1, Pérez López R.2, Luis M.M.3, Pablos Hernández C.1,2, Julián Enríquez J.M.2,4, Juan Francisco Blanco Blanco J.F.4 1 Geriatric Unit. Complejo Asistencial Universitario de Salamanca. Salamanca (Spain). 2 Orthogeriatric Unit. Complejo Asistencial Universitario de Salamanca. Salamanca (Spain). 3 Internal Medicine Department. Centro Hospitalar Gaia/Espinho. Porto (Portugal). 4 Orthopedic Surgery and Trauma Service. Complejo Asistencial Universitario de Salamanca. Salamanca (Spain).
The geriatric patient is particularly susceptible to serious side effects (falls, delirium, daily somnolence) of psychotropics (benzodiazepines, hypnotics, neuroleptics). Therefore, its withdrawal could possibly improve their quality of life. When considering psychotropic withdrawal, trazodone presents an ubiquitary action and a safe profile.
INTRODUCTION
To implement a psychotropic prescription withdrawal by alternative prescription of trazodone in an Orthogeriatric Unit during hip fracture perioperative period.
OBJECTIVES
Retrospective observational descriptive study. Population: 65-year-old patients or older with hip fracture consecutively admitted in an Orthogeriatric Unit (June 2015 – May 2016). Inclusion criteria: on > 3 month psychotropic treatment, eventual psychotropic side effects. Source: Medora®, Farmatools®, anamnesis and global geriatric assessment file. Database and statistical analysis: FilemakerPro®.
MATERIAL AND METHODS
N= 51 patients; 82.4% women; mean age 88 years old; 8.6 medicines per patient; 6 patients: more than 1 medicine withdrawal; 34 immediate replacement; 10: dose reduction; 9: posology frequency reduction. Removal of 44 benzodiazepines, 5 hypnotics, 2 tricyclic antidepressant. 100% started trazodone as an alternative treatment.
RESULTS Sex 17.6% 82.4%
MALE FEMALE
N=51 patients
NUMBER OF PATIENTS IMMEDIATE REPLACEMENT
34
DOSE REDUCTION
10
POSOLOGY FREQUENCY REDUCTION
9
Mean age 88 ± 7.28 years
BIBLIOGRAPHY
CONCLUSIONS
100% started trazodone as an alternative treatment.
Actions concerning psychotropics
Medication Removal 5
2
BENZODIAZEPINES
44
HYPNOTICS TRICYCLIC AD
51 DRUGS REMOVED FROM 51 PATIENTS
Prescription follow up monitoring: 42 patients maintained prescription switch recommendation.
• In patients presenting psychotropic adverse side effects, trazodone could be an adequate therapeutic alternative on psychotropic withdrawal. • The stay in Orthogeriatric Units due to hip fracture could be a suitable moment to assess the convenience of withdrawal, reduction or substitution of some chronic medications, specially psychotropics.
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