Evidence map›Paper›PMID 20808119›Full record

ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2010

Antipsychotic and benzodiazepine use among nursing home residents: findings from the 2004 National Nursing Home Survey.

David G Stevenson, Sandra L Decker, Lisa L Dwyer, Haiden A Huskamp, David C Grabowski, Eran D Metzger, Susan L Mitchell

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 5 pooled it
4.5field-weighted citation impact, top 5% 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

38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 104 citations in OpenAlex.

  1. Pooled it
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  6. Trial
  7. Article
  8. Falls prediction using the nursing home minimum dataset.Journal of the American Medical Informatics Association : JAMIA · 2022
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  18. Where Are Antipsychotics Prescribed in Nursing Homes Initiated?Journal of the American Geriatrics Society · 2018
    Article
  19. Observational
  20. Comparing the care needs of people living with and without HIV in Canadian home and long-term care settings.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

David G StevensonDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA. stevenson@hcp.med.harvard.edu
Sandra L Decker
Lisa L Dwyer
Haiden A Huskamp
David C Grabowski
Eran D Metzger
Susan L Mitchell
Beth Israel Deaconess Medical Center · USNational Center for Health Statistics · USHarvard Pilgrim Health Care · USHebrew SeniorLife · US

Funding

Substance Abuse Treatment Pathways for Employee GroupsP50DA010233 · NIDA · BRANDEIS UNIVERSITY · PI HORGAN, CONSTANCE M. · 1995 to 2008
$6.8M
Midcareer Mentoring Award for Patient-Oriented Research in AgingK24AG033640 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI MITCHELL, SUSAN L · 2009 to 2018
$1.8M
NIA NIH HHS K24 AG033640NIDA NIH HHS P50 DA010233
6 · The paper itself

Abstract

objectivesTo document the extent and appropriateness of use of antipsychotics and benzodiazepines among nursing home residents using a nationally representative survey.

methodsCross-sectional analysis of the 2004 National Nursing Home Survey. Bivariate and multivariate analyses examined relationships between resident and facility characteristics and antipsychotic and benzodiazepine use by appropriateness classification among residents aged 60 years and older (N = 12,090). Resident diagnoses and information about behavioral problems were used to categorize antipsychotic and benzodiazepine use as appropriate, potentially appropriate, or having no appropriate indication.

resultsMore than one quarter (26%) of nursing home residents used an antipsychotic medication, 40% of whom had no appropriate indication for such use. Among the 13% of residents who took benzodiazepines, 42% had no appropriate indication. In adjusted analyses, the odds of residents taking an antipsychotic without an appropriate indication were highest for residents with diagnoses of depression (odds ratio [OR] = 1.31; 95% confidence interval [CI]: 1.12-1.53), dementia (OR = 1.82; 95% CI: 1.52-2.18), and with behavioral symptoms (OR = 1.97, 95% CI: 1.56-2.50). The odds of potentially inappropriate antipsychotic use increased as the percentage of Medicaid residents in a facility increased (OR = 1.08, 95% CI: 1.02-1.15) and decreased as the percentage of Medicare residents increased (OR = 0.46, 95% CI: 0.25-0.83). The odds of taking a benzodiazepine without an appropriate indication were highest among residents who were female (OR = 1.44; 95% CI: 1.18-1.75), white (OR = 1.95; 95% CI: 1.47-2.60), and had behavioral symptoms (OR = 1.69; 95% CI: 1.41-2.01).

conclusionAntipsychotics and benzodiazepines seem to be commonly prescribed to residents lacking an appropriate indication for their use.

Indexed as

AgedAged, 80 and overAntipsychotic AgentsBenzodiazepinesDrug UtilizationFemaleHealth Care SurveysHumansMaleMental DisordersMiddle AgedNursing HomesUnited StatesAntipsychotic AgentsBenzodiazepines

Identifiers

PMID20808119
PMCPMC3009456
OpenAlexW1988273295

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.