Journal:Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):15, 96, 8, Supplement 3, S256-S273, S273.e1-S273.e.14
Study identified psychotropic medication administration patterns during inpatient rehabilitation for traumatic brain injury (TBI) and examined their relationship to patient preinjury and injury characteristics. Data were obtained from 2,130 patients admitted to 10 acute inpatient rehabilitation centers as part of a comparative effectiveness study in which patient characteristics, environmental factors, and interventions were evaluated to identify factors associated with key TBI inpatient rehabilitation outcomes. Most frequently administered were narcotic analgesics, followed by antidepressants, anticonvulsants, anxiolytics, hypnotics, stimulants, antipsychotics, antiparkinson agents, and miscellaneous psychotropics. The psychotropic agents studied were administered to 95 percent of the sample, with 8.5 percent receiving only 1 and 31.8 percent 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 older patients 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, 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.