title: Does being assisted by care workers affect antipsychotics prescription among older people discharged from hospital?
abstract: OBJECTIVE
  Several factors can affect antipsychotic prescriptions, among which, caregivers. However, whether being assisted by a care worker might increase the rate of antipsychotic prescriptions at discharge from acute care hospital has not been previously investigated. We aimed to investigate whether being assisted by a care worker is associated with increased use of antipsychotics among older patients discharged from acute care hospitals.
  
  
  METHODS
  The present series consisted of 928 patients not taking antipsychotics at admission in seven acute care wards of geriatric medicine in Italy (mean age 80.8 ± 7.2 years, 54.9% women). The outcome of the study was defined as receiving an antipsychotic prescription at discharge. Patients were grouped according to their living conditions as follows: (i) living alone; (ii) living only with care worker; (iii) living with care worker and family members; and (iv) living only with family members. The association between study variables and antipsychotic prescription at discharge was investigated by logistic regression analysis.
  
  
  RESULTS
  After adjusting for potential confounders, being assisted by care workers was significantly associated with the outcome (OR 2.64, 95% CI 1.21-5.75). Diagnosis of dementia (OR 2.73, 95% CI 1.65-4.51), instrumental activities of daily living limitations (OR 1.12, 95% CI 1.05-1.21) and delirium during stay (OR 3.87, 95% CI 2.01-7.47) also qualified as independent correlates of antipsychotic prescription at discharge.
  
  
  CONCLUSIONS
  Being assisted by care workers could increase the likelihood of receiving antipsychotics at discharge from acute care hospitals. Geriatr Gerontol Int 2017; 17: 1707-1713.
authors.affiliation: Laboratory of Studies and Research in Biostatistics, National Institute of Health and Science on Aging (INRCA), Ancona, Italy.
authors.forename: Mirko
authors.initials: M
authors.lastname: Di Rosa
authors.affiliation: Laboratory of Studies and Research in Biostatistics, National Institute of Health and Science on Aging (INRCA), Ancona, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fabbietti
authors.affiliation: Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), Cosenza, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Corsonello
authors.affiliation: Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), Cosenza, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fusco
authors.affiliation: Department of Gerontology, Neuroscience and Orthopedics, Catholic University of Sacread Hearth, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Sganga
authors.affiliation: Section of Internal and Cardiorespiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.affiliation: Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Carmelinda
authors.initials: C
authors.lastname: Ruggiero
authors.affiliation: Department of Gerontology, Neuroscience and Orthopedics, Catholic University of Sacread Hearth, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Scientific Direction, Italian National Research Center on Aging (INRCA), Cosenza, Italy.
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Lattanzio
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D017028:Caregivers; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D010351:Patient Discharge; D012111:Residence Characteristics
chemical_list: D014150:Antipsychotic Agents
keywords: Italy; antipsychotics; care workers; hospital Discharge