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Abstract
Background: This study assessed the use of medications during inpatient post-acute rehabilitation for acquired brain injury (ABI).
Materials and methods: All inpatients with ABI undergoing post-acute rehabilitation in centres identified through the roster of the Italian Society for Rehabilitation Medicine were included. A designated physician in each centre collected information through a structured questionnaire. This study calculated (a) prevalence of medication use, (b) logistic regression Odds Ratio (OR), with 95% confidence interval (95% CI), of polypharmacy (≥ 6 medications).
Results: A total of 484 patients (median age = 52 years, 63.4% men, median time from acute event = 18.5 weeks) were included; 33.8% had Rancho Los Amigos Levels of Cognitive Functioning Scale (RLAS) score 1–2, 8.1% had a score of 7–8, of whom 92.0% received medications, 51.8% had a score of 6–10, of whom 83.9% had at least one psychotropic medication and 66.9% had two or more; 51.8% received anti-epileptics, 32.1% anti-depressants, 14.5% anti-psychotics, peaking in RLAS 4 (37.3%) and decreasing in RLAS 7–8. Polypharmacy was directly associated with age (55–64 years, OR = 2.1; 95% CI = 1.1–4.1; ≥ 65 years, OR = 1.7; 95% CI = 0.9–3.3), inversely with RLAS score (1-2 vs 7–8, OR = 4.3; 95% CI = 1.9–9.8).
Conclusion: Polypharmacy and concurrent use of psychotropic medications was common, raising concern about drug–drug interactions. Safety and effectiveness of medications should be monitored, particularly when used concurrently.
Declaration of Interest
The authors report no conflicts of interest. This study was funded by the non-profit organization Italian Association for Traumatic Brain Injuries (Federazione Nazionale Associazioni Traumi Cranici, FNATC) and by the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA) through Farmacovigilance Funds.
