Polypharmacy in Australian Veterans with Post-traumatic Stress Disorder upon Admission to a Mental Health Facility: A Retrospective Chart Review

Abstract

Objective Polypharmacy increases the risk of adverse drug events and drug–drug interactions, and contributes to falls, hospital admissions, morbidity and mortality. Veterans with post-traumatic stress disorder often have psychological and physical comorbidities, increasing the likelihood of general and psychotropic polypharmacy. This study investigates the prevalence of general and psychotropic polypharmacy in inpatient veterans with post-traumatic stress disorder, and illustrates potential risks associated with polypharmacy in this population. Methods Medical records of 219 veterans admitted to a mental health facility for post-traumatic stress disorder management were retrospectively reviewed. Medication lists on admission were extracted and coded according to Anatomical Therapeutic Chemical Classification classes. The prevalence of general (five or more total medications), psychotropic (two or more N-code medications), and sedative (two or more medications with sedating effects) polypharmacy and Drug Burden Index were calculated. Class combinations were reported, and associations between demographic characteristics and polypharmacy were determined. Results Mean age was 62.5 (± 14.6) years. In addition to post-traumatic stress disorder, 90.9% had a diagnosis of at least one other psychiatric condition, and 96.8% had a diagnosis of at least one non-psychiatric medical condition. The prevalence of general polypharmacy was 76.7%, psychotropic polypharmacy was 79.9% and sedative polypharmacy was 75.3%. Drug Burden Index scores ranged from 0 to 8.2, with 66.2% of participants scoring ≥ 1. Conclusions This cohort of inpatient veterans with post-traumatic stress disorder had a high prevalence of general, psychotropic and sedative polypharmacy, and were at high risk for drug-related adverse events. This highlights the importance of increasing awareness of polypharmacy and potentially inappropriate drug combinations, and the need for improved medication review by prescribers. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-022-00298-3.

Factors Associated with Symptoms of Posttraumatic Stress in Mothers During the COVID-19 Pandemic

“…Some studies have mentioned the use of medications by people with PTSD, including not only medications to treat the disease itself, but also analgesics (Schwartz et al, 2006 ) and medications to treat insomnia and nightmares (Sareen, 2014 ). These patients are often polypharmacy users, using other medications in addition to psychotropics (Mellor et al, 2022 ). Due to the possible consequences of polypharmacy, regular monitoring of the prescribed drugs and frequent dialogue with prescribers are necessary.…”

“…Due to the possible consequences of polypharmacy, regular monitoring of the prescribed drugs and frequent dialogue with prescribers are necessary. Furthermore, health professionals need to place greater emphasis on implementing non-pharmacological interventions, such as psychosocial interventions and physical activity (Mellor et al, 2022 ), which can provide a better quality of life for these people.…”

“…Exposure to traumatic and stressful events can lead to the development of acute stress disorder and posttraumatic stress disorder, related to symptoms such as anxiety, sleep changes and somatic complaints (Figueira & Mendlowicz, 2003 ). Posttraumatic stress disorder (PTSD) is a complex mental health condition (Sareen, 2014 ) that has a substantial impact on the individual and society (Mellor et al, 2022 ).…”