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    Variation in nursing home antipsychotic prescribing rates.

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    Authors
    Rochon, Paula A.
    Stukel, Therese A.
    Bronskill, Susan E.
    Gomes, Tara
    Sykora, Kathy
    Wodchis, Walter P.
    Hillmer, Michael
    Kopp, Alexander
    Gurwitz, Jerry H.
    Anderson, Geoffrey M.
    UMass Chan Affiliations
    Department of Medicine, Division of Geriatric Medicine
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2007-04-09
    Keywords
    Aged
    Aged, 80 and over
    Antipsychotic Agents
    Drug Utilization
    Female
    Humans
    Male
    Nursing Homes
    Health Services Research
    Medicine and Health Sciences
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1001/archinte.167.7.676
    Abstract
    BACKGROUND: Excessive prescribing of antipsychotic therapy is a concern owing to their potential to cause serious adverse events. We explored variation in the use of antipsychotic therapy across nursing homes in Ontario, Canada, and determined if prescribing decisions were based on clinical indications. METHODS: A point-prevalence study of antipsychotic therapy use in 47 322 residents of 485 provincially regulated nursing homes in December 2003. Facilities were classified into quintiles according to their mean antipsychotic prescribing rates. Residents were grouped into those with a potential clinical indication or no identified clinical indication for antipsychotic therapy. RESULTS: A total of 15 317 residents (32.4%) were dispensed an antipsychotic agent. The mean rate of antipsychotic prescribing by home ranged from 20.9% in the quintile of facilities with the lowest mean prescribing rates (quintile 1) to 44.3% in facilities with the highest mean prescribing rates (quintile 5). Compared with individuals residing in nursing homes with the lowest mean antipsychotic prescribing rates, those residing in facilities with the highest rates were 3 times more likely to be dispensed an antipsychotic agent (adjusted odds ratio [AOR], 3.0; 95% confidence interval [CI], 2.74-3.19). Similar rates were observed among residents with psychoses with or without dementia (AOR, 2.7; 95% CI, 2.35-3.09) and residents without psychoses or dementia (AOR, 2.9; 95% CI, 2.19-3.81) who had no identifiable indication for an antipsychotic therapy. CONCLUSION: Residents in facilities with high antipsychotic prescribing rates were about 3 times more likely than those in facilities with low prescribing rates to be dispensed an antipsychotic agent, irrespective of their clinical indication.
    Source
    Arch Intern Med. 2007 Apr 9;167(7):676-83.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37099
    PubMed ID
    17420426; 17420426
    Related Resources
    Link to article in PubMed
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    UMass Chan Faculty and Researcher Publications

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