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dc.contributor.authorRochon, Paula A.
dc.contributor.authorStukel, Therese A.
dc.contributor.authorBronskill, Susan E.
dc.contributor.authorGomes, Tara
dc.contributor.authorSykora, Kathy
dc.contributor.authorWodchis, Walter P.
dc.contributor.authorHillmer, Michael
dc.contributor.authorKopp, Alexander
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorAnderson, Geoffrey M.
dc.date2022-08-11T08:09:23.000
dc.date.accessioned2022-08-23T16:28:48Z
dc.date.available2022-08-23T16:28:48Z
dc.date.issued2007-04-09
dc.date.submitted2009-09-25
dc.identifier.citationArch Intern Med. 2007 Apr 9;167(7):676-83.
dc.identifier.issn0003-9926
dc.identifier.pmid17420426
dc.identifier.pmid17420426
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37099
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.publisherAmerican Medical Association
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17420426&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/archinte.167.7.676
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAntipsychotic Agents
dc.subjectDrug Utilization
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectNursing Homes
dc.subjectHealth Services Research
dc.subjectMedicine and Health Sciences
dc.titleVariation in nursing home antipsychotic prescribing rates.
dc.typeJournal Article
dc.source.journaltitleArchives of internal medicine
dc.source.volume167
dc.source.issue7
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/48
dc.identifier.contextkey1016861
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathmeyers_pp/48
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute


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