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Evaluation of Anxiolytic and Antipsychotic Use at Inpatient Rehabilitation Hospital During the COVID-19 Pandemic

Hannah Farmer, DO (University of Missouri-Columbia PM&R Program, Columbia, Missouri); Benjamin Gill, DO, MBA; Claire Finkel, MD; Kelli Buchanan; Wendy Pierce Martin, PharmD; Zaheer Ahmad

Meeting: AAPM&R Annual Assembly 2021

Categories: Pandemic (2021)

Session Information

Session Title: Research Spotlight: Pandemic

Session Time: None. Available on demand.

Disclosures: Hannah Farmer, DO: No financial relationships or conflicts of interest

Objective: To evaluate the administration of anxiolytic and antipsychotic medications to patients in an inpatient rehabilitation facility during coronavirus disease-19 (COVID-19) pandemic.

Design: Case-control studySetting : Inpatient Rehabilitation Facility (IRF)Participants : All patients admitted to IRF during four months prior to and four months after the declaration of the COVID-19 pandemic.

Interventions: Not applicable

Main Outcome Measures: Total number of administrations of medications by month. Average doses of each medication per patient.

Results: Data were collected for a total of eight months: four months prior to (October 2019 to January 2020) and four months after (October 2020 to January 2021) the declaration of the COVID-19 pandemic in March 2020. Medications reviewed were quetiapine, propranolol, hydroxyzine, and benzodiazepines. Relative to before the pandemic, there was a nonsignificant reduction in total administrations of propranolol, benzodiazepines, and hydroxyzine (39%, 38%, 25% reduction, respectively). There was an increase in total administrations of quetiapine (104% increase). The average dose of quetiapine per patient increased during the pandemic, although not to a significant degree. The average dose of propranolol per patient decreased or remained stable following the pandemic. The average doses of hydroxyzine and benzodiazepines did not demonstrate a consistent change after the pandemic.Conclusions: Although the hypothesis was that anxiolytic use would increase, these data reveal there was a reduction in use of anxiolytic medications at this institution since the declaration of the COVID-19 pandemic. The reduction in anxiolytic medications may be due to improved nonpharmacologic means of managing anxiety. Further evaluation is needed to determine if use of maintenance medications for anxiety was impacted by the pandemic. Administration of antipsychotic medications increased during the pandemic, which may indicate an overall increase in agitation in patients over this period. However, agitation requiring pharmacologic intervention could be due to visitor restrictions or institutional masking policy, both of which may contribute to delirium in an IRF setting.

Level of Evidence: Level III

To cite this abstract in AMA style:

Farmer H, Gill B, Finkel C, Buchanan K, Martin WP, Ahmad Z. Evaluation of Anxiolytic and Antipsychotic Use at Inpatient Rehabilitation Hospital During the COVID-19 Pandemic [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/evaluation-of-anxiolytic-and-antipsychotic-use-at-inpatient-rehabilitation-hospital-during-the-covid-19-pandemic/. Accessed May 20, 2025.
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