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Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates

Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates ORIGINAL INVESTIGATION Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates Yong Chen, MD, MHS; Becky A. Briesacher, PhD; Terry S. Field, DSc; Jennifer Tjia, MD; Denys T. Lau, PhD; Jerry H. Gurwitz, MD Background: Serious safety concerns related to the use the antipsychotic medication users, 32% (n=1545) had of antipsychotics have not decreased the prescribing of no identified clinical indication for this therapy. Resi- these agents to nursing home (NH) residents. We as- dents entering NHs with the highest facility-level anti- sessed the extent to which resident clinical characteris- psychotic rates were 1.37 times more likely to receive an- tics and institutional prescribing practice were associ- tipsychotics relative to those entering the lowest ated with antipsychotic prescribing. prescribing rate NHs, after adjusting for potential clini- cal indications (risk ratio [RR], 1.37; 95% confidence in- Methods: Antipsychotic prescribing was assessed for a terval [CI], 1.24-1.51). The elevated risk associated with nationwide, cross-sectional population of 16 586 newly facility-level prescribing rates was apparent for only NH admitted NH residents in 2006. We computed facility- residents with dementia but no psychosis (RR, 1.40; 95% level antipsychotic rates based on the previous year’s CI, 1.23-1.59) and residents without dementia or psy- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates

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References (27)

Publisher
American Medical Association
Copyright
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2009.469
pmid
20065204
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL INVESTIGATION Unexplained Variation Across US Nursing Homes in Antipsychotic Prescribing Rates Yong Chen, MD, MHS; Becky A. Briesacher, PhD; Terry S. Field, DSc; Jennifer Tjia, MD; Denys T. Lau, PhD; Jerry H. Gurwitz, MD Background: Serious safety concerns related to the use the antipsychotic medication users, 32% (n=1545) had of antipsychotics have not decreased the prescribing of no identified clinical indication for this therapy. Resi- these agents to nursing home (NH) residents. We as- dents entering NHs with the highest facility-level anti- sessed the extent to which resident clinical characteris- psychotic rates were 1.37 times more likely to receive an- tics and institutional prescribing practice were associ- tipsychotics relative to those entering the lowest ated with antipsychotic prescribing. prescribing rate NHs, after adjusting for potential clini- cal indications (risk ratio [RR], 1.37; 95% confidence in- Methods: Antipsychotic prescribing was assessed for a terval [CI], 1.24-1.51). The elevated risk associated with nationwide, cross-sectional population of 16 586 newly facility-level prescribing rates was apparent for only NH admitted NH residents in 2006. We computed facility- residents with dementia but no psychosis (RR, 1.40; 95% level antipsychotic rates based on the previous year’s CI, 1.23-1.59) and residents without dementia or psy-

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jan 11, 2010

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