Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit
Background There is a high incidence of serious mental illness (SMI) and antipsychotic use in the respiratory high dependence unit (HDU) compared with the general population. However, there is a paucity of data in the extant literature evaluating the relationships between respiratory failure and ant...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-11-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424007737/type/journal_article |
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| _version_ | 1846141394669797376 |
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| author | Sara Winter Tara Kirkpatrick Karl Winckel Faraz Honarparvar Lewis Robinson Timothy Tanzer Lesley Smith Nicola Warren Dan Siskind Claire Michelle Ellender |
| author_facet | Sara Winter Tara Kirkpatrick Karl Winckel Faraz Honarparvar Lewis Robinson Timothy Tanzer Lesley Smith Nicola Warren Dan Siskind Claire Michelle Ellender |
| author_sort | Sara Winter |
| collection | DOAJ |
| description | Background
There is a high incidence of serious mental illness (SMI) and antipsychotic use in the respiratory high dependence unit (HDU) compared with the general population. However, there is a paucity of data in the extant literature evaluating the relationships between respiratory failure and antipsychotics.
Aims
To investigate the relationship between antipsychotics and respiratory failure in people admitted to a respiratory HDU, and to gain a better understanding of the potential impact of antipsychotic medications on respiratory outcomes.
Method
Medical, demographic and clinical outcome data were collected for a consecutive sample of 638 individuals admitted to a respiratory HDU between the dates 1 January 2018 and 29 May 2021 at a large quaternary hospital.
Results
Multivariate models controlling for confounders found that antipsychotic medications increased risk of admission for type 2 respiratory failure and chronic obstructive pulmonary disease exacerbation without hypercapnia by 3.7 and 11.45 times, respectively. For people admitted with type 2 respiratory failure, antipsychotic use increased the risk of requiring non-invasive ventilation by 4.9 times. Those prescribed an antipsychotic were more likely to be readmitted within 30 days. Over 30% of individuals were prescribed antipsychotics for an unlicensed indication.
Conclusions
Poor respiratory outcomes may be a previously unknown adverse drug reaction of antipsychotics. Modifications to clinical care and clinical pathways for those with SMI prescribed antipsychotic medications, including optimising their chronic health and deprescribing where appropriate, should be prioritised.
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| format | Article |
| id | doaj-art-559af4fe630543ed8eff3491b486ea0e |
| institution | Kabale University |
| issn | 2056-4724 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-559af4fe630543ed8eff3491b486ea0e2024-12-04T10:17:55ZengCambridge University PressBJPsych Open2056-47242024-11-011010.1192/bjo.2024.773Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unitSara Winter0https://orcid.org/0009-0001-6054-9762Tara Kirkpatrick1Karl Winckel2Faraz Honarparvar3Lewis Robinson4Timothy Tanzer5Lesley Smith6Nicola Warren7Dan Siskind8https://orcid.org/0000-0002-2072-9216Claire Michelle Ellender9Faculty of Medicine, University of Queensland, Brisbane, Australia Department of Psychology, West Moreton Health and Hospital Service, Queensland Health, Brisbane, Australia Queensland Centre for Mental Health Research, Brisbane, AustraliaPharmacy Department, Princess Alexandra Hospital, Brisbane, AustraliaPharmacy Department, Princess Alexandra Hospital, Brisbane, Australia School of Pharmacy, The University of Queensland, Brisbane, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Ipswich Hospital, Ipswich, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Metro South Addiction and Mental Health Service, Brisbane, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia School of Pharmacy, The University of Queensland, Brisbane, AustraliaPharmacy Department, Princess Alexandra Hospital, Brisbane, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Metro South Addiction and Mental Health Service, Brisbane, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Metro South Addiction and Mental Health Service, Brisbane, AustraliaFaculty of Medicine, University of Queensland, Brisbane, Australia Department of Respiratory & Sleep Medicine, Princess Alexandra Hospital, Brisbane, AustraliaBackground There is a high incidence of serious mental illness (SMI) and antipsychotic use in the respiratory high dependence unit (HDU) compared with the general population. However, there is a paucity of data in the extant literature evaluating the relationships between respiratory failure and antipsychotics. Aims To investigate the relationship between antipsychotics and respiratory failure in people admitted to a respiratory HDU, and to gain a better understanding of the potential impact of antipsychotic medications on respiratory outcomes. Method Medical, demographic and clinical outcome data were collected for a consecutive sample of 638 individuals admitted to a respiratory HDU between the dates 1 January 2018 and 29 May 2021 at a large quaternary hospital. Results Multivariate models controlling for confounders found that antipsychotic medications increased risk of admission for type 2 respiratory failure and chronic obstructive pulmonary disease exacerbation without hypercapnia by 3.7 and 11.45 times, respectively. For people admitted with type 2 respiratory failure, antipsychotic use increased the risk of requiring non-invasive ventilation by 4.9 times. Those prescribed an antipsychotic were more likely to be readmitted within 30 days. Over 30% of individuals were prescribed antipsychotics for an unlicensed indication. Conclusions Poor respiratory outcomes may be a previously unknown adverse drug reaction of antipsychotics. Modifications to clinical care and clinical pathways for those with SMI prescribed antipsychotic medications, including optimising their chronic health and deprescribing where appropriate, should be prioritised. https://www.cambridge.org/core/product/identifier/S2056472424007737/type/journal_articleRespiratory failureantipsychoticsserious mental illness |
| spellingShingle | Sara Winter Tara Kirkpatrick Karl Winckel Faraz Honarparvar Lewis Robinson Timothy Tanzer Lesley Smith Nicola Warren Dan Siskind Claire Michelle Ellender Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit BJPsych Open Respiratory failure antipsychotics serious mental illness |
| title | Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| title_full | Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| title_fullStr | Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| title_full_unstemmed | Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| title_short | Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| title_sort | antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit |
| topic | Respiratory failure antipsychotics serious mental illness |
| url | https://www.cambridge.org/core/product/identifier/S2056472424007737/type/journal_article |
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