European Geriatric Medicine - Supplement 1 - Volume 6 - September 2015

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S156 Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156
P-460
Relationship between elderly patients taking antidepressant
and hospital admissions
N. Ortuno1, J. Cobo1, M. Suarez Linares 2, B. Garcia Garcia2 ,
G. Guzman Gutierrez2, E. Gonzalez1 , G. Inmaculada1 , M.D. Ferrer1,
C. Campos1, N. Planet1 , J.C. Oliva1, G. Garcia Pares1
1Corporaci´o Sanit`aria i Universit`aria Parc Taul´ı, Sabadell, Spain;
2Hospital Monte Naranco, Oviedo, Spain
Objective: Determine the impact of antidepressant treatment as
an independent protective factor for emergency hospitalizations in
people aged 65 and over.
Methods: All patients 65 years and older, who visit Parc Taul´ı
Hospital’s Emergency Department between January and October
2012, were included. A total of 36176 medical emergencies
were attended; 15791 (43.65%) were 65 years or older, and
25.93% were admitted. Sociodemographic variables, medical
history, polypharmacy, cognitive pathology and toxic consumption
were obtained. The current psychopharmacological treatment
was collected. Sample size was performed to obtain significant
differences. Simple randomization, a descriptive statistical analysis,
and parametric tests were performed by using a statistical computer
software.
Results: 674 patients (53% women) were evaluated, with mean
age 78.45±7.93. 27.6% of cases (71% women) were receiving
antidepressants. 83 individuals (24.6%) among the total number of
admitted patients (337), and 103 cases (30.6%) among the patients
who were not admitted, previously used antidepressant treatment.
All the treatment dosages are within the therapeutic range. After a
comparative analysis, the relationship between the previous use of
antidepressant treatment and being admitted to hospital was not
statistically significant in our global sample. This relationship was
statistically significant among the group of sample aged 75 and
over (c2 = 6.610, fd = 1, sig. 0.012).
Conclusions: Antidepressant treatment is associated with a
decreased risk of hospital admission for urgent medical conditions
in people aged 75 and over. This may be a protective factor against
their admission at Emergency department and potentially may be a
quality criterion to prevent complications in this population group.
P-461
A clinical rule increases adequate monitoring in patients using
lithium in a general hospital
F. van Gorp1 , E. Kuck2 , M. Sonnen3, G. Hugenholtz 2 , T. Egberts4,
I. Wilting4
1Department of Pharmacy, Diakonessenhuis Utrecht, Utrecht,
Netherlands; 2Department of Pharmacy, Diakonessenhuis, Utrecht,
Netherlands; 3Department of Psychiatry, Diakonessenhuis, Utrecht,
Netherlands; 4Department of Clinical Pharmacy, University Medical
Centre, Utrecht, Netherlands
Objectives: Admission to a general hospital increases the risk for
supra- or subtherapeutic lithium concentrations in patients using
lithium. This may result in either lithium toxicity or psychiatric
deterioration. We aimed to investigate whether introducing a
clinical rule selecting patients using lithium followed by intensified
monitoring of lithium treatment improves patient safety.
Methods: Patients ≥18 years using lithium from May 2009 to
October 2013 during admission to the Diakonessenhuis, a general
hospital in the Netherlands, were included. Adequateness of
monitoring of lithium treatment before and after implementation
of a clinical rule was evaluated retrospectively. The clinical rule
identifies admitted patients using lithium and prompts the clinical
pharmacist to collect information regarding lithium treatment
and inform the clinical psychiatrist. Consequently, the psychiatrist
proactively suggests a psychiatric consult to the treating physician.
Adequate monitoring was defined as a preventive psychiatric
consult and a serum lithium level within 48 hours after admission.
Results: 107 admitted patients before and 136 admitted patients
after implementation of the clinical rule were included. Adequate
monitoring (preventive psychiatric consult and serum lithium level
within 48 hours) was more frequent after implementation of the
clinical rule (26.5% vs. 7.5%, p< 0.001). Results were similar for
patients ≥65 years (23.3% vs 7.9%, p = 0.02) compared to those
<65 years (30.2% vs 6.8%, p = 0.003).
Conclusions: This clinical rule is effective in improving adequate
monitoring of patients using lithium during hospitalisation on a
somatic ward. This intervention may improve patient safety in this
vulnerable subgroup of patients during general hospital admission.