Third, we were able to obtain prescribing but not dispensing information therefore, some patients may not have received the drug. Second, use for sleep may have been misclassified if delirium was not adequately recorded in the medical record however, the separation of the doses suggests that we excluded much of the nonsleep use. Our study has limitations first, our single academic center experience may not be generalizable to nonacademic centers or outside of Quebec. 4 Hospitalized and acutely ill older adults may be particularly susceptible to the neurocognitive adverse effects. 3 There is a limited number of studies examining off-label quetiapine use and adverse drug events, 2 but associations with anticholinergic events and urinary tract symptoms are described in older adults with dementia, and sedation, fatigue, weight gain, and extrapyramidal symptoms in users irrespective of age. The proportion of patients who received quetiapine off-label for sleep was similar to that in a recent study of outpatients who received quetiapine for any off-label indication (66% vs 67% Pā=ā.41). About half of this use was continued at discharge (5.9%) including 1 in 7 patients who were first introduced to the medication as a sleep aid while in hospital. In our single-center study of 1001 older medical inpatients, quetiapine was given to 1 in 8 patients (13.0%) with nearly two-thirds of the use being for sleep. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. Clinical Implications of Basic Neuroscience.
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