Longitudinal Trends and Variation in Antipsychotic Use in Older Adults After Cardiac Surgery

Abstract

Objectives: To evaluate temporal trends and between-hospital variation in off-label antipsychotic medication (APM) use in older adults undergoing cardiac surgery. Design: Retrospective cohort study. Setting: National administrative database including 465 U.S. hospitals. Participants: Individuals aged 65 and older without known indications for APMs who underwent cardiac surgery from 2004 to 2014 (N=293,212). Measurements: Postoperative exposure to any APMs and potentially excessive dosing were examined. Hospital-level APM prescribing intensity was defined as the proportion of individuals newly treated with APMs in the postoperative period. Results: The rate of APM use declined from 8.8% in 2004 to 6.2% in 2014 (p