Abstract
Background: This study assessed the use of medications during inpatient post-acute rehabilitation for acquired brain injury (ABI).Materials and methods: All inpatients with ABI undergoing post-acute rehabilitation in centres identified through the roster of the Italian Society for Rehabilitation Medicine were included. A designated physician in each centre collected information through a structured questionnaire. This study calculated (a) prevalence of medication use, (b) logistic regression Odds Ratio (OR), with 95% confidence interval (95% CI), of polypharmacy (≥ 6 medications).Results: A total of 484 patients (median age = 52 years, 63.4% men, median time from acute event = 18.5 weeks) were included; 33.8% had Rancho Los Amigos Levels of Cognitive Functioning Scale (RLAS) score 1–2, 8.1% had a score of 7–8, of whom 92.0% received medications, 51.8% had a score of 6–10, of whom 83.9% had at least one psychotropic medication and 66.9% had two or more; 51.8% received anti-epileptics, 32.1% anti-depressants, 14.5% anti-psychotics, peaking in RLAS 4 (37.3%) and decreasing in RLAS 7–8. Polypharmacy was directly associated with age (55–64 years, OR = 2.1; 95% CI = 1.1–4.1; ≥ 65 years, OR = 1.7; 95% CI = 0.9–3.3), inversely with RLAS score (1-2 vs 7–8, OR = 4.3; 95% CI = 1.9–9.8).Conclusion: Polypharmacy and concurrent use of psychotropic medications was common, raising concern about drug–drug interactions. Safety and effectiveness of medications should be monitored, particularly when used concurrently.
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