title: Psychotropic drug changes contributing to readmissions in medically hospitalized psychiatric patients: A retrospective study.
abstract: Psychotropic drug changes during medical hospitalizations may lead to psychiatric and medical readmissions.
  
  
  
  One-year hospitalization records of nursing home patients with chronic mental illness and a psychotropic drug change during medical admission were reviewed. We calculated the readmission rates for 30, 60, and 90 days; the classes of the psychotropic drugs changed; the reason for change; and the specialties of the responsible physicians. The readmission rates were compared with those of an age-matched control group.
  
  
  
  The changes were associated with an increase in psychiatric readmission rates of 2.7% (30 days), 5.4% (60 days), and 14.9% (90 days). The 90 days readmission rate reached statistical significance (14.9% vs 2.7%; OR = 6.29; P = .020). The family practice team was responsible for the highest psychiatric readmission rate (18.4%). The most significant reasons for change included human errors (up to 40%), which is alarming.
  
  
  
  Judicious changes, attempts at re-titration, and appropriate documentation of reasons for change on discharge records may reduce the readmission rates.
authors.affiliation: Department of Psychiatry, St. John's Episcopal Hospital-South Shore, Far Rockaway, NY USA. E-mail: sdanan@ehs.org.
authors.forename: Subramoniam
authors.initials: S
authors.lastname: Madhusoodanan
authors.forename: Biling
authors.initials: B
authors.lastname: Xu
authors.forename: Srikanth
authors.initials: S
authors.lastname: Prayaga
authors.forename: Piotr
authors.initials: P
authors.lastname: Slowik
authors.forename: Ronald
authors.initials: R
authors.lastname: Brenner
authors.forename: Wallace
authors.initials: W
authors.lastname: Thomas
authors.forename: Natalie
authors.initials: N
authors.lastname: Schwartz
mesh_terms: D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D011619:Psychotropic Drugs