Antipsychotic prescription patterns in the management of delirium symptoms in hospitalized elderly patients

Abstract

Objective: The objective of this study was to study the pharmacological management of delirium in elderly hospitalized patients in acute geriatric medical wards. Method: We conducted a one-year retrospective cross-sectional study in patients 65 years of age or older who were admitted to an acute geriatric unit care at a teaching hospital with a delirium diagnosis. Results: A total of 133 subjects were included in the study. Delirium was prevalent in 78% of patients. The average length of delirium was 13 days. Antipsychotics were prescribed to 74% of patients with delirium. Patients with hyperactive, mixed and hypoactive delirium received antipsychotics regularly in a proportion of 68%, 54%, and 34% respectively. The length of antipsychotic prescription was of 11 days. Risperidone was the most commonly prescribed agent given on a regular basis while haloperidol was chosen for the as required prescriptions. Fifty-five percent of demented patients received a daily prescription of antipsychotics compared to 46% in the non-demented population. A shorter length of delirium episodes in subjects with acetylcholinesterase inhibitors was also observed. A higher mortality rate was observed in the group of subjects receiving benzodiazepine during the delirium episode. Conclusion: This study shows that antipsychotic treatment is widely, but not systematically prescribed in demented and non-demented patients in all types of delirium including hypoactive. Efforts should be made to increase appropriate antipsychotic prescription in this vulnerable population.