Antipsychotic prescribing in people admitted to hospital with dementia or delirium

Objective: To evaluate antipsychotic prescribing in people with dementia or delirium admitted to a large regional Queensland hospital.

Methods: A retrospective observational study analysing medical records of patients prescribed antipsychotics over 6 months.

Results: We audited a sample of 141 patients, 65 years or over (over 45 years for indigenous peoples) with dementia or delirium, without severe mental illness, prescribed antipsychotics. Over a third (35%) were prescribed antipsychotics prior to admission, with 73% prescribed a new antipsychotic in hospital. Only 23% received documented review of antipsychotic therapy. Under half (48%) had evidence of non-pharmacological interventions as first-line management. Sixty-eight patients (48%) were discharged with antipsychotics; however, only 4% were provided an antipsychotic management plan.

Conclusion: Initiation and continuation of antipsychotics in patients with dementia or delirium in hospital is common, with infrequent review. There is significant potential to reduce prescribing antipsychotics in people admitted to hospital with dementia or delirium.