Evidence map›Paper›PMID 20065204›Full record

ArticleArchives of internal medicine2010

Unexplained variation across US nursing homes in antipsychotic prescribing rates.

Yong Chen, Becky A Briesacher, Terry S Field, Jennifer Tjia, Denys T Lau, Jerry H Gurwitz

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PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 3 pooled it
38.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 3 syntheses or guidelines pooled it, 203 citations in OpenAlex.

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  19. Economic Barriers to Antiretroviral Therapy in Nursing Homes.Journal of the American Geriatrics Society · 2020
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Yong ChenMeyers Primary Care Institute, University of Massachusetts Medical School, Worcester, 01605, USA.
Becky A Briesacher
Terry S Field
Jennifer Tjia
Denys T Lau
Jerry H Gurwitz
University of Massachusetts Chan Medical School · US

Funding

Cost-related Underuse of Medications and the Health of Older AdultsK01AG031836 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI BRIESACHER, BECKY A · 2008 to 2012
$679k
Caregiving Skills in Effective Medication Management for Hospice PatientsK01AG027295 · NIA · UNIVERSITY OF ILLINOIS AT CHICAGO · PI LAU, DENYS · 2007 to 2011
$611k
Prescription Drug Coverage and Health Outcomes in EldersK08AG021527 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI TJIA, JENNIFER · 2004 to 2008
$598k
NIA NIH HHS K01 AG027295NIA NIH HHS K01AG027295NIA NIH HHS K01 AG031836NIA NIH HHS K01AG031836NIA NIH HHS K08AG021527
6 · The paper itself

Abstract

backgroundSerious safety concerns related to the use of antipsychotics have not decreased the prescribing of these agents to nursing home (NH) residents. We assessed the extent to which resident clinical characteristics and institutional prescribing practice were associated with antipsychotic prescribing.

methodsAntipsychotic prescribing was assessed for a nationwide, cross-sectional population of 16 586 newly admitted NH residents in 2006. We computed facility-level antipsychotic rates based on the previous year's (2005) prescribing patterns. Poisson regressions with generalized estimating equations were used to identify the likelihood of resident-level antipsychotic medication use in 2006, given 2005 facility-level prescribing pattern and NH resident indication for antipsychotic therapy (psychosis, dementia, and behavioral disturbance).

resultsMore than 29% (n = 4818) of study residents received at least 1 antipsychotic medication in 2006. Of the antipsychotic medication users, 32% (n = 1545) had no identified clinical indication for this therapy. Residents entering NHs with the highest facility-level antipsychotic rates were 1.37 times more likely to receive antipsychotics relative to those entering the lowest prescribing rate NHs, after adjusting for potential clinical indications (risk ratio [RR], 1.37; 95% confidence interval [CI], 1.24-1.51). The elevated risk associated with facility-level prescribing rates was apparent for only NH residents with dementia but no psychosis (RR, 1.40; 95% CI, 1.23-1.59) and residents without dementia or psychosis (RR, 1.54; 95% CI, 1.24-1.91).

conclusionsThe NH antipsychotic prescribing rate was independently associated with the use of antipsychotics in NH residents. Future research is needed to determine why such a prescribing culture exists and whether it could result in adverse health consequences.

Indexed as

Nursing HomesAgedAged, 80 and overAntipsychotic AgentsChi-Square DistributionCognition DisordersCross-Sectional StudiesFemaleHumansMaleMiddle AgedPoisson DistributionPractice Patterns, Physicians'United StatesAntipsychotic Agents

Identifiers

PMID20065204
PMCPMC2897009
OpenAlexW1993728084

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.