994: CONTINUATION OF NEWLY INITIATED INTENSIVE CARE THERAPIES AT ICU DISCHARGE

Abstract

Introduction: Patients in the ICU are more likely to experience medication errors than other hospitalized patients. One common error is drug therapy initiated in the ICU for short-term use may be inadvertently continued at ICU and hospital discharge. Multiple medication classes have historically been investigated for their inappropriate continuation. New literature shows continuation of atypical antipsychotics, midodrine, and opioids at rates even higher than the historically studied classes. The goal of this study was to quantify the percentage of continuation of each therapy at ICU discharge at our facility compared to reported literature. Methods: We conducted a single-center, retrospective chart review of patients who received either an atypical antipsychotic, midodrine, or a continuous fentanyl infusion in the ICU between January 1, 2020, and August 15, 2021. Because fentanyl infusions are often utilized for analgosedation in intubated patients and discontinued prior to ICU discharge, we evaluated for continuation of other opioids post-fentanyl infusion. Patients were evaluated in reverse chronological order from date of admission for inclusion and exclusion criteria until 30 patients from each class were identified or all patients were evaluated. Results: Four hundred two patients were evaluated with eighty-five included in the study: atypical antipsychotics=25, midodrine=30, opioids=30. The percentage of continuation at ICU discharge was 48% for atypical antipsychotics, 63% for midodrine, and 13% for opioids. Conclusions: Similar to previously published literature, we identified a relatively large percentage of newly initiated ICU therapies continued at ICU discharge. Additional larger studies are needed to evaluate inappropriate vs appropriate continuation as well as clinical implications of continuation.