Sedatives and analgesics are major contributors to potentially inappropriate duplicate prescriptions in geriatric psychiatry.
Martin Schulze Westhoff, Sebastian Schr��der, Adrian Groh, Helge Frieling, Stefan Bleich, Felix Koop, Dirk O Stichtenoth, Benjamin Krichevsky, Johannes Heck
Author Information
Martin Schulze Westhoff: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. ORCID
Sebastian Schr��der: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. ORCID
Adrian Groh: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. ORCID
Helge Frieling: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. ORCID
Stefan Bleich: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. ORCID
Felix Koop: Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany. ORCID
Dirk O Stichtenoth: Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany. ORCID
Benjamin Krichevsky: Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany. ORCID
Johannes Heck: Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany. ORCID
BACKGROUND: This study sought to investigate the frequency and characteristics of duplicate prescriptions (DPs) in elderly psychiatric inpatients using a novel categorisation of DPs that differentiates between appropriate duplicate prescriptions (ADPs) and potentially inappropriate duplicate prescriptions (PIDPs). METHODS: The study was conducted as a monocentric retrospective cross-sectional pilot study on the gerontopsychiatric ward of the Department of Psychiatry, Social Psychiatry and Psychotherapy of Hannover Medical School, a large university hospital in northern Germany. The outcome measures were the nature and frequency of PIDPs compared with the frequency of ADPs. RESULTS: For 92 individual patients a total of 339 medication chart reviews were conducted between April 2021 and February 2022. The median age of the study population was 73���years (interquartile range (IQR) 68-82���years); 64.6% were female. Patients' medications comprised a median of eight drugs (IQR 6-11 drugs) and 43.1% of the study population were exposed to at least one PIDP (at least one grade-1 PIDP: 39.5%; at least one grade-2 PIDP: 5.0%; at least one grade-3 PIDP: 1.5%). Sedatives were most frequently responsible for grade-1 and grade-2 PIDPs, while grade-3 PIDPs were elicited exclusively by analgesics. Nearly half of the study population (49.0%) displayed at least one ADP. CONCLUSION: Even though the clinical implications of PIDPs are not fully established to date, we recommend that physicians who treat elderly psychiatric patients pay special attention to PIDPs, especially PIDPs elicited by sedatives. Termination of PIDPs may prevent adverse drug reactions and save healthcare expenditures.
