TOPLINE:

In a multicenter emergency department (ED) cohort of patients on chronic psychiatric medications, restarting outpatient medications within 24 hours was not associated with the overall length of stay in the entire cohort; however, among patients who restarted their medications, early resumption may be linked to a shorter stay.

METHODOLOGY:

• Researchers conducted a retrospective, multicenter cohort study and analyzed data from 250 patients aged 16 years or older with an ED length of stay > 24 hours who had a psychiatric diagnosis and were on outpatient psychiatric medications, based on encounters from 2022 to 2024.
• Participants were divided into two cohorts according to whether outpatient psychiatric medications were resumed within 24 hours (n = 96) or after 24 hours/never resumed (n = 154).
• The primary outcome was the ED length of stay, and secondary outcomes included sitter hours, restraint hours, the number of psychiatric medication administrations, and discharge disposition.
• A post hoc subgroup analysis was conducted among patients whose outpatient medications were resumed.

TAKEAWAY:

• No significant difference was observed in mean ED length of stay between the early resumption (< 24 hours) and delayed/never resumption groups. Similarly, secondary outcomes did not differ significantly between the groups.
• In the subgroup analysis, patients who resumed medications within 24 hours had a significantly shorter mean ED length of stay than those who resumed after 24 hours (47.7 vs 65.7 hours; P = .0004).
• An increased number of home medications was significantly associated with medication resumption within 24 hours (odds ratio, 1.3; P = .007).

IN PRACTICE:

"In patients ≥ 16 years of age presenting with psychiatric emergency to the emergency department, early resumption of outpatient medications was not associated with increased ED length of stay, sitter use, or restraint use. However, in patients with their outpatient medications resumed, early resumption was correlated with a shorter ED LOS [length of stay]," the authors wrote.

SOURCE:

The study was led by Morgan Hayslip, PharmD, Mount Carmel Health System, Columbus, Ohio. It was published online on November 6, 2025, in The American Journal of Emergency Medicine.

LIMITATIONS:

The retrospective nature and small sample size of the study may have influenced the results. The absence of a widely accepted scale to quantify psychiatric emergency severity may have introduced bias. Statistically significant differences in baseline characteristics between groups may also have contributed to bias. Additionally, sitter use may have been affected by the inclusion of patients with an involuntary hold status.

DISCLOSURES:

The study did not receive any funding. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.