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Prevalence of medication and off-label medication use in acquired brain injury at a neurorehabilitation hospital

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

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.

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Acknowledgements

We thank Mrs. Raquel López and Mr. Eloy Opisso for their help with statistical analysis. We are also indebted to Christine O’Hara who helped to prepare the English version of the manuscript.

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Authors and Affiliations

  1. Pharmacy Service, Institut Guttmann, Neurorehabilitation Hospital, Camí de Can Ruti s/n, 08916, Badalona, Barcelona, Spain

    Raquel Merino, Ana Pérez & Josana Fierro

  2. Neurorehabilitation Unit, Institut Guttmann, Neurorehabilitation Hospital, Camí de Can Ruti s/n, 08916, Badalona, Barcelona, Spain

    Rosa Terré

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  1. Raquel Merino
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  4. Rosa Terré
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Contributions

RM designed the study, performed the research, analysed the data and wrote the manuscript. RT designed the study, analysed the data and wrote the manuscript. AP and JF analysed the data.

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Correspondence to Raquel Merino.

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Merino, R., Pérez, A., Fierro, J. et al. Prevalence of medication and off-label medication use in acquired brain injury at a neurorehabilitation hospital. Eur J Clin Pharmacol 75, 985–994 (2019). https://doi.org/10.1007/s00228-019-02651-y

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  • DOI: https://doi.org/10.1007/s00228-019-02651-y

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