@article{ref1,
title="Psychotropic medication use among medicare beneficiaries following traumatic brain injury",
journal="American journal of geriatric psychiatry",
year="2016",
author="Albrecht, Jennifer S. and Mullins, Daniel C. and Smith, Gordon C. S. and Rao, Vani",
volume="25",
number="4",
pages="415-424",
abstract="OBJECTIVES: To characterize psychotropic medication use before and after traumatic brain injury (TBI) hospitalization among older adults. A secondary objective is to determine how receipt of indicated pharmacologic treatment for anxiety and post-traumatic stress disorder (PTSD) differs following TBI. <br><br>DESIGN: Retrospective cohort. SETTING: United States. PARTICIPANTS: Medicare beneficiaries aged ≥65 years hospitalized with TBI between 2006 and 2010 with continuous drug coverage for 12 months before and after TBI (N = 60,276). MEASUREMENTS: We obtained monthly psychotropic medication use by drug class and specific drugs from Medicare Part D drug event files.ICD-9 codes were used to define anxiety (300.0x) and PTSD (309.81). <br><br>RESULTS: Average monthly prevalence of psychotropic medication use among all patients hospitalized for TBI was 44.8%; antidepressants constituted 73%. Prevalence of psychotropic medication use increased from 2006 to 2010. Following TBI, psychotropic medication use increased slightly (OR: 1.05; 95% CI: 1.03, 1.06.) Tricyclic antidepressant use decreased post-TBI (OR: 0.76; 95% CI: 0.73, 0.79) whereas use of the sedating antidepressants mirtazapine (OR: 1.31; 95% CI: 1.25, 1.37) and trazadone (OR: 1.11; 95% CI: 1.06, 1.17) increased. Antipsychotic (OR: 1.15; 95% CI: 1.12, 1.19) use also increased post-TBI. Beneficiaries newly diagnosed with anxiety (OR: 0.42; 95% CI: 0.36, 0.48) and/or PTSD (OR: 0.39; 95% CI: 0.18, 0.84) post-TBI were less likely to receive indicated pharmacologic treatment. <br><br>CONCLUSIONS: Older adults hospitalized with TBI have a high prevalence of psychotropic medication use yet are less likely to receive indicated pharmacological treatment for newly diagnosed anxiety and PTSD following TBI.<br><br>Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1064-7481",
doi="10.1016/j.jagp.2016.11.018",
url="http://dx.doi.org/10.1016/j.jagp.2016.11.018"
}