1. Prescribing practice and off-label use of psychotropic medications in post-acute brain injury rehabilitation centres: A cross-sectional survey
- Author
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Pisa, Federica Edith, Cosano, Giorgia, Giangreco, Manuela, Giorgini, Tullio, Biasutti, Emanuele, Barbone, Fabio, Formisano, R., Buzzi, M. G., Pistarini, C., Aiachini, B., Basaglia, Nino, Montis, A., Lucca, L. F., Lombardi, F., Ranza, E., Vallasciani, M., Celentano, A., Naldi, A., Castellani, G., Lamberti, G., Lanzillo, B., Posteraro, F., Logi, F., Molteni, F., Lanfranchi, M., Gramigna, C., Bertagnoni, G., Dell'Oste, P., Tonin, P., Iaia, V., Sagliocco, L., Beatrici, M., Giunta, N., Dore, T., Galardi, G., Sant'Angelo, N., Piperno, R., Battistini, A., Zampolini, M., Scarponi, F., Sanna, V., Biella, A. M., Premoselli, S., Zaro, F., Bernasconi, K., Carnovali, M., Chierici, S., Antenucci, R., Salvi, G. P., Mazzini, N., Ventura, F., Lonati, M. C., Brianti, R., Mammi, P., Molinero, G., De Tanti, A., Bertolino, C., Boldrini, P., Bargellesi, S., and Tessari, A.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cross-sectional study ,medicine.medical_treatment ,Neuroscience (miscellaneous) ,Practice Patterns ,Logistic regression ,Off-label use ,Rehabilitation Centers ,NO ,Pharmacotherapy ,Arts and Humanities (miscellaneous) ,medicine ,Antiepileptic agents ,Prevalence ,Developmental and Educational Psychology ,Antipsychotics ,Humans ,Practice Patterns, Physicians' ,Psychiatry ,Survey ,Psychotropic Drugs ,Rehabilitation ,Physicians' ,Off-label ,business.industry ,Pharmacoepidemiology ,Acquired brain injuries ,Antidepressants ,Prescribing ,Psychotropic medications ,Brain Injuries ,Cross-Sectional Studies ,Female ,Italy ,Middle Aged ,Off-Label Use ,Neurology (clinical) ,Odds ratio ,Confidence interval ,Emergency medicine ,business - Abstract
Guidance on pharmacotherapy of neurobehavioural sequelae post-acquired brain injury (ABI) is limited. Clinicians face the choice of prescribing off-label. This survey assesses prescribing practice and off-label use of psychotropic medications in Italian brain injury rehabilitation centres and factors associated with atypical antipsychotics use.Centres were identified through the roster of the Italian Society for Rehabilitation Medicine. Information was collected through a structured questionnaire. This study calculated the prevalence of centres reporting to use off-label individual medications and unconditional logistic regression Odds Ratio (OR), with 95% confidence interval (95% CI) of atypical antipsychotics use.Psychotropic medications were commonly used. More than 50% of the 35 centres (participation ratio 87.5%) reported to use off-label selected antipsychotics, mostly for agitation (90.5%) and behavioural disturbances (19.0%), and antidepressants, mostly for insomnia (37.5%) and pain (25.0%). Atypical antipsychotic use was directly associated with age40 years (OR = 2.68; 95% CI = 1.25-5.76), recent ABI (1.74; 0.74-4.09), not with reported off-label use (0.98; 0.44-2.18).In clinical practice, the effectiveness and safety of medications, in particular off-label, should be systematically monitored. Studies are needed to improve the quality of evidence guiding pharmacotherapy and to evaluate effectiveness and safety of off-label prescribing.
- Published
- 2015