ArticleJournal of the American Geriatrics Society2011
Potential underuse, overuse, and inappropriate use of antidepressants in older veteran nursing home residents.
Article in Journal of the American Geriatrics Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 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
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Evaluation of the heterogeneity of studies estimating the association between risk factors and the use of potentially inappropriate drug therapy for the elderly: a systematic review with meta-analysis.European journal of clinical pharmacology · 2015Pooled it
- Central Nervous System-Active Medications and Risk of Hospital Readmission in Older Multimorbid Adults.Journal of the American Geriatrics Society · 2025Trial
- Pharmacist Identification of Medication Therapy Problems Involving Cognition Among Older Adults Followed by a Home-Based Care Team.Drugs & aging · 2021Trial
- Potential influence of long-term medication on physical performance in the context of long-term rehabilitation process in soldiers: a retrospective cohort analysis.Frontiers in rehabilitation sciences · 2025Article
- Challenges and Opportunities in Managing Geriatric Depression: The Role of Personalized Medicine and Age-Appropriate Therapeutic Approaches.Pharmaceutics · 2024Review
- Article
- Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review.BMC psychiatry · 2023Article
- Prevalence, progress, and subgroup disparities in pharmacological antidepressant treatment of those who screen positive for depressive symptoms: A repetitive cross-sectional study in 19 European countries.The Lancet regional health. Europe · 2022Article
- Concordance of self- and informant-rated depressive symptoms in nursing home residents with Dementia: cross-sectional findings.BMC psychiatry · 2022Article
- Review
- Pretreatment screening and counseling on prolonged erections for patients prescribed trazodone.Investigative and clinical urology · 2021Article
- Provincial legislative and regulatory standards for pain assessment and management in long-term care homes: a scoping review and in-depth case analysis.BMC geriatrics · 2020Article
- Antidepressants in nursing homes for dependent older patients: the cross-sectional associations of institutional factors with prescription conformance.European geriatric medicine · 2019Article
- Article
- Frequency and predictors of the potential overprescribing of antidepressants in elderly residents of a geographically defined U.S. population.Pharmacology research & perspectives · 2019Article
- Optimization of Antidepressant use with Pharmacogenetic Strategies.Current genomics · 2017Article
- Fall and Fracture Risk in Nursing Home Residents With Moderate-to-Severe Behavioral Symptoms of Alzheimer's Disease and Related Dementias Initiating Antidepressants or Antipsychotics.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017Article
- Non-tricyclic and Non-selective Serotonin Reuptake Inhibitor Antidepressants and Recurrent Falls in Frail Older Women.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2016Article
- The Role of Opioid Analgesics in Geriatric Pain Management.Clinics in geriatric medicine · 2016Review
- Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review.Revista latino-americana de enfermagem · 2016Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 4 countries.
Funding
Abstract
objectivesTo examine prevalence and resident- and site-level factors associated with potential underuse, overuse, and inappropriate use of antidepressants in older Veterans Affairs (VA) Community Living Center (CLC) residents.
designLongitudinal study.
settingOne hundred thirty-three VA CLCs.
participantsThree thousand six hundred ninety-two veterans aged 65 and older admitted between January 1, 2004, and June 3, 2005, with long stays (≥ 90 days). MEASUREMENTS: Prevalence of potential underuse, inappropriate use, and overuse of antidepressants in residents with and without depression (as documented according to International Classification of Diseases, Ninth Revision, Clinical Modification, codes or Depression Rating Scale).
resultsSelective serotonin reuptake inhibitors were the most commonly prescribed antidepressant. Of the 877 residents with depression, 25.4% did not receive an antidepressant, suggesting potential underuse. Of residents with depression who received antidepressants, 57.5% had potential inappropriate use due primarily to problems seen with drug-drug and drug-disease interactions. Of the 2,815 residents who did not have depression, 1,190 (42.3%) were prescribed one or more antidepressants; only 48 (4.0%) of these had a Food and Drug Administration-approved labeled indication, suggesting potential overuse. Overall, only 17.6% of antidepressant use was appropriate (324/1,844). The only consistent resident factor associated with potential underuse and overuse use was taking an antipsychotic without evidence of schizophrenia (underuse: adjusted relative risk ratio (ARRR)=0.56, 95% confidence interval (CI)=0.33-0.94; overuse: adjusted odds ratio=1.52, 95% CI=1.21-1.91). Having moderate to severe pain (ARRR=1.54, 95% CI=1.08-2.20) and the prescribing of an anxiolytic or hypnotic (ARRR=1.33, 95% CI=1.02-1.74) increased the risk of potential inappropriate antidepressant use.
conclusionPotential problems with the use of antidepressants were frequently observed in older U.S. veteran CLC residents. Future studies are needed to examine the true risks and benefits of antidepressant use in CLC and non-VA nursing homes.
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Registered trials
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