Psychotropic prescribing after hospital discharge in survivors of critical illness, a retrospective cohort study (2012–2019)

Elizabeth T Mansi*, Christopher T Rentsch, Richard S Bourne, Bruce Guthrie, Nazir I Lone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background:Many people survive critical illness with the burden of new or worsened mental health issues and sleep disturbances. We examined the frequency of psychotropic prescribing after critical illness, comparing critical care to non-critical care hospitalised survivors, and whether this varied in important subgroups.Methods:This retrospective cohort study included 23,340 critical care and 367,185 non-critical care hospitalised adults from 2012 through 2019 in Lothian, Scotland, who survived to discharge.Results:One-third of critical care survivors (32 7527/23,340) received a psychotropic prescription within 90 days after hospital discharge (25 14hypnotics; 4mania medicines). In contrast, 1554,589/367,185) of non-critical care survivors received a psychotropic prescription (12 5hypnotics; 2mania medicines). Among patients without psychotropic prescriptions within 180 days prior to hospitalisation, after hospital discharge, the critical care group had a higher incidence of psychotropic prescription (10.3 1610/15,609) compared with the non-critical care group (3.2 9743/307,429); unadjusted hazard ratio (HR) 3.39, 95 3.22–3.57. After adjustment for potential confounders, the risk remained elevated (adjusted HR 2.03, 95 1.91–2.16), persisted later in follow-up (90–365 days; adjusted HR 1.38, 95 1.30–1.46), and was more pronounced in those without recorded comorbidities (adjusted HR 3.49, 95 3.22–3.78).Conclusions:Critical care survivors have a higher risk of receiving psychotropic prescriptions than hospitalised patients, with a significant proportion receiving benzodiazepines and other hypnotics. Future research should focus on the requirement for and safety of psychotropic medicines in survivors of critical illness, to help guide policy for clinical practice.
Original languageEnglish
Number of pages10
JournalJournal of the Intensive Care Society
Early online date19 Jan 2024
DOIs
Publication statusE-pub ahead of print - 19 Jan 2024

Keywords / Materials (for Non-textual outputs)

  • Psychotropic drugs
  • critical care
  • critical Illness
  • post-intensive care syndrome
  • mental disorders

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