Table 2.
Inpatient Antipsychotic Use Characteristics Among Veterans Hospitalized for Heart Failure and Discharged to a Skilled Nursing Facility, 2010–2015
| Antipsychotic characteristics during index HF admission |
Overall (n = 1931) |
Antipsychotics D/C’d prior to discharge (n = 1516) |
Antipsychotics continued into SNFs (n = 415) |
Standardized mean difference |
|---|---|---|---|---|
| Day of hospital admission antipsychotic started, median (Q1, Q3) | 4.0 (2.0, 7.0) | 4.0 (2.0, 7.0) | 3.0 (2.0, 6.0) | − 0.14 |
| Number of days antipsychotic administered, median (Q1, Q3) | 3.0 (1.0, 7.0) | 2.0 (1.0, 6.0) | 8.0 (4.0, 13.0) | 0.71 |
| Proportion (%) of days antipsychotics administered, median (Q1, Q3) | 26.7 (11.6, 57.1) | 20.0 (10.0, 42.9) | 62.9 (40.0, 82.4) | 1.21 |
| Type of antipsychotic, n (%) | 0.78 | |||
| Typical only | 808 (41.8) | 741 (48.9) | 67 (16.1) | |
| Atypical only | 657 (34.0) | 479 (31.6) | 178 (42.9) | |
| Both typical and atypical | 466 (24.1) | 296 (19.5) | 170 (41.0) | |
| Antipsychotic route of administration, n (%) | 0.08 | |||
| Oral only | 891 (46.1) | 666 (43.9) | 226 (54.5) | |
| Parenteral only | 482 (25.0) | 473 (31.2) | 14 (3.4) | |
| Both oral and parenteral | 528 (27.3) | 377 (24.9) | 175 (42.2) | |
| Admissions with at least one day of potentially excessive antipsychotic dosing, n (%)* | ||||
| Any antipsychotic exposure | 858 (44.4) | 677 (44.7) | 181 (43.6) | − 0.41 |
| Exposure to typical antipsychotics only | 447 (55.3) | 418 (56.4) | 29 (43.2) | − 0.49 |
| Exposure to atypical antipsychotics only | 68 (10.4) | 36 (7.5) | 32 (18.0) | 0.20 |
| Exposure to both typical and atypical antipsychotics | 343 (73.6) | 223 (75.3) | 120 (70.6) | − 0.37 |
| Number of days with potentially excessive antipsychotic dosing, mean (SD)* | ||||
| Any antipsychotic exposure | 1.5 (3.5) | 1.3 (3.2) | 2.1 (4.4) | 0.20 |
| Exposure to typical antipsychotics only | 1.4 (2.7) | 1.3 (2.5) | 2.1 (4.2) | 0.23 |
| Exposure to atypical antipsychotics only | 0.6 (2.4) | 0.3 (1.7) | 1.2 (3.6) | 0.30 |
| Exposure to both typical and atypical antipsychotics | 3.0 (5.2) | 2.9 (5.3) | 3.1 (5.1) | 0.03 |
| Proportion (%) of days with potentially excessive antipsychotic dosing, mean (SD)* | ||||
| Any antipsychotic exposure | 9.7 (17.8) | 8.6 (15.9) | 13.4 (23.3) | 0.24 |
| Exposure to typical antipsychotics only | 10.5 (16.9) | 10.2 (15.9) | 14.4 (25.1) | 0.20 |
| Exposure to atypical antipsychotics only | 4.2 (16.3) | 2.5 (11.9) | 8.6 (24.1) | 0.32 |
| Exposure to both typical and atypical antipsychotics | 15.9 (19.1) | 14.7 (18.1) | 17.9 (20.7) | 0.16 |
HF heart failure, D/C’d discontinued, SNF skilled nursing facility, Q1 quartile 1, Q3 quartile 3, SD standard deviation
*Denominators are the corresponding cells from the “Type of antipsychotic” variable