ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2009
Association of antipsychotic use with hospital events and mortality among medicare beneficiaries residing in long-term care facilities.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medications and Prescribing Patterns as Factors Associated with Hospitalizations from Long-Term Care Facilities: A Systematic Review.Drugs & aging · 2018Pooled it
- Relapse risk after discontinuation of risperidone in Alzheimer's disease.The New England journal of medicine · 2012Trial
- The antipsychotic discontinuation in Alzheimer disease trial: clinical rationale and study design.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2012Trial
- Citalopram for agitation in Alzheimer's disease: design and methods.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2012Trial
- A 6-month, randomized, double-blind, placebo-controlled pilot discontinuation trial following response to haloperidol treatment of psychosis and agitation in Alzheimer's disease.International journal of geriatric psychiatry · 2011Trial
- Hallucinations, Antipsychotic Use, and Mortality in Older Adults with Dementia: Retrospective Cohort Study of Two Medicare-Linked National Health Surveys.Drugs & aging · 2022Article
- Initiation of antipsychotics after moving to residential aged care facilities and mortality: a national cohort study.Aging clinical and experimental research · 2021Article
- Racial and ethnic differences in psychotropic medication use among community-dwelling persons with dementia in the United States.Aging & mental health · 2018Article
- Increased All-Cause Mortality by Antipsychotic Drugs: Updated Review and Meta-Analysis in Dementia and General Mental Health Care.Journal of Alzheimer's disease reports · 2018Article
- Risk of Adverse Outcomes for Older People with Dementia Prescribed Antipsychotic Medication: A Population Based e-Cohort Study.Neurology and therapy · 2017Article
- Persistent use of psychotropic drugs in nursing home residents in Norway.BMC geriatrics · 2017Article
- Use of pharmacy dispensing data to measure adherence and identify nonadherence with oral hypoglycemic agents.European journal of clinical pharmacology · 2017Article
- Potentially high-risk medication categories and unplanned hospitalizations: a case-time-control study.Scientific reports · 2017Article
- A Review of Adverse Outcomes Associated with Psychoactive Drug Use in Nursing Home Residents with Dementia.Drugs & aging · 2016Review
- Interchangeability, Safety and Efficacy of Modified-Release Drug Formulations in the USA: The Case of Opioid and Other Nervous System Drugs.Clinical drug investigation · 2016Article
- Elder-Clowning in Long-Term Dementia Care: Results of a Pilot Study.Journal of the American Geriatrics Society · 2016Article
- Assessment and management of behavioral and psychological symptoms of dementia.BMJ (Clinical research ed.) · 2015Review
- Molecular imaging of neuropsychiatric symptoms in Alzheimer's and Parkinson's disease.Neuroscience and biobehavioral reviews · 2015Review
- Effect of medications on physical function and cognition in nursing home residents with dementia.Journal of the American Geriatrics Society · 2014Article
- Pharmacotherapeutic management of dementia across settings of care.Journal of the American Geriatrics Society · 2013Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveAntipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.
designRetrospective analysis using sequential multivariate Cox proportional hazards models.
settingMedicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.
participantsA total of 2,363 LTC Medicare beneficiaries, 1999-2002. MEASUREMENTS: Trends in LTC AP use overall and by type and duplicative use; association of AP utilization and two outcomes: hospital events and all-cause mortality.
resultsAP use rose markedly from 1999 to 2002 (26.4%-35.9%), predominantly due to increased use of atypical agents. After controlling for sociodemographic and clinical factors, AP use is not related to hospital events (hazard ratio [HR] = 0.98, 95% confidence interval [CI] = 0.82-1.63 p = 0.7951). AP use is associated with reduced mortality in unadjusted and intermediate models, but loss of significance in the final model (HR = 0.83, 95% CI = 0.69-1.00, p = 0.0537) suggests that disease and drug burden factors may confound the AP-mortality relationship.
conclusionThis study provides no evidence of increased hospital events or mortality in LTC residents who use AP medications. Findings contribute to a growing body of evidence that APs, particularly atypical agents, may be associated with reduced mortality in LTC residents.
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