Prevalence of Medication and Off-label Medication Use in Acquired Brain Injury at a Neurorehabilitation Hospital

Overview

Journal Eur J Clin Pharmacol

Specialty Pharmacology

Date 2019 Mar 6

PMID 30834963

Citations 2

Authors

Raquel Merino

Ana Perez

Josana Fierro

Rosa Terre

Affiliations

Soon will be listed here.

Abstract

Purpose: Patients who suffer acquired brain injury (ABI) require a great variety of drugs. Furthermore, the lack of evidence on the medication effects in this type of patient increases off-label prescription. The aim of this study was to describe the pattern of medication use and the practice of prescribing off-label drugs in these patients.

Methods: A cross-sectional study was conducted in patients with ABI, of either traumatic or non-traumatic cause, admitted to a neurorehabilitation hospital for rehabilitation. Demographic and clinical data and prevalence of medication use and off-label prescription were collected.

Results: The majority of the studied patients (85.2%) were considered polymedicated since they were prescribed ≥ 6 drugs concomitantly. In traumatic brain injury (TBI) patients, antidepressants (81.5%) were the Anatomical Therapeutic Chemical (ATC) group's most prescribed versus antithrombotic agents (80.5%) in non-traumatic brain injury (N-TBI) patients. Up to 37.3% of all active substances prescribed in TBI patients were off-label compared with 24.9% in N-TBI patients. The most prescribed off-label active substances in both groups were those related to the Nervous System (N) ATC group to treat neurobehavioural problems.

Conclusion: A multidisciplinary pharmacotherapeutic follow-up of these patients would be essential to address the high prescription rate of medications and the off-label prescription practice. In this way, medication problems related to polypharmacy could be minimised and the benefit-risk ratio of prescribed off-label drugs could be ensured according to the available medical evidence.

Citing Articles

Medication utilization in traumatic brain injury patients-insights from a population-based matched cohort study.

Molero Y, Sharp D, DOnofrio B, Lichtenstein P, Larsson H, Fazel S Front Neurol. 2024; 15:1339290.

PMID: 38385038 PMC: 10879380. DOI: 10.3389/fneur.2024.1339290.

Psychotropic and pain medication use in individuals with traumatic brain injury-a Swedish total population cohort study of 240 000 persons.

Molero Y, Sharp D, DOnofrio B, Larsson H, Fazel S J Neurol Neurosurg Psychiatry. 2021; 92(5):519-527.

PMID: 33563808 PMC: 8053342. DOI: 10.1136/jnnp-2020-324353.

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