SHM Converge Scientific Abstract ePoster Gallery-Discharge Planning Gaps for Newly Initiated Antipsychotics in Hospitalized Patients With Delirium

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This retrospective quality improvement study examined 97 delirium consults seen by the Consult-Liaison Psychiatry team at a large academic hospital from June to August 2024 to assess how newly started scheduled antipsychotics were managed at discharge.<br /><br />Delirium is common in hospitalized patients, and antipsychotics are often used to control acute hyperactive symptoms. However, if these medications are not clearly discontinued after the delirium resolves, they may be continued long term and expose patients to harms such as extrapyramidal symptoms, arrhythmias, metabolic syndrome, and orthostasis.<br /><br />Among the consults reviewed, half of patients were started on a new scheduled antipsychotic during hospitalization. The most common agents were quetiapine, olanzapine, and haloperidol. At discharge, 48% of these newly started antipsychotics had been stopped, 10% were continued with a clear plan to taper or stop, and 42% were continued without any discontinuation plan. In addition, for those discharged on antipsychotics without a plan, the most recent psychiatry consult note failed to recommend tapering or stopping in 85% of cases.<br /><br />The findings suggest a major gap in discharge planning and communication around antipsychotic use for delirium. The authors conclude that better collaboration between the primary and consulting teams is needed to improve medication safety during transitions of care. A proposed next step is standardizing psychiatry consult documentation to explicitly address anticipated discharge medication plans.

Asset Subtitle

Christine Nguyen

Meta Tag

Author List Christine Nguyen, Elias Khawam, Jessica Donato, Pilar Lachhwani

Category Research

Concept Delirium

Concept Antipsychotic

Concept Discharge Planning

Concept Long-Term Use

Concept Medication Continuation

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic

Presenting Author Christine Nguyen

Track Quality Improvement

Keywords

delirium

consult-liaison psychiatry

antipsychotics

discharge planning

medication safety

quetiapine

olanzapine

haloperidol

quality improvement

transitions of care

Delirium

Antipsychotic

Discharge Planning

Long-Term Use

Medication Continuation