Evidence map›Paper›PMID 28122506›Full record

SynthesisBMC geriatrics2017

Variation in use of antipsychotic medications in nursing homes in the United States: A systematic review.

Hannah Cioltan, Samah Alshehri, Carol Howe, Jeannie Lee, Mindy Fain, Howard Eng, Kenneth Schachter, Jane Mohler

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC geriatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 4 pooled it
5.6field-weighted citation impact, top 3% 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

39 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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  11. Impact of national partnership to improve dementia care on antipsychotic use duration for dementia residents in nursing homes.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
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  13. COVID-19 Factors Associated With Medication Changes Among Nursing Home Residents With Dementia.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
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  18. Did the COVID-19 Pandemic Affect the Use of Antipsychotics Among Nursing Home Residents With ADRD?The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023
    Observational
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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

8 authors at 1 institution in 1 country.

Hannah CioltanCollege of Public Health, University of Arizona, Tucson, Arizona, USA. hstocker@aging.arizona.edu.ORCID 0000-0003-4775-4304
Samah AlshehriCollege of Pharmacy, University of Arizona, Tucson, Arizona, USA.
Carol HoweUniversity of Arizona Health Sciences Library, Tucson, USA.
Jeannie LeeArizona Center on Aging, College of Medicine, University of Arizona, Tucson, Arizona, USA.
Mindy FainArizona Center on Aging, College of Medicine, University of Arizona, Tucson, Arizona, USA.
Howard EngCollege of Public Health, University of Arizona, Tucson, Arizona, USA.
Kenneth SchachterCollege of Public Health, University of Arizona, Tucson, Arizona, USA.
Jane MohlerCollege of Public Health, University of Arizona, Tucson, Arizona, USA.
University of Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of antipsychotic medications (APMs) in nursing home residents in the U.S. is an increasingly prominent issue and has been associated with increased risk of hospitalization, cardiovascular events, hip fractures, and mortality, among other adverse health events. The Food and Drug Administration has placed a black box warning on these drugs, specifying that they are not meant for residents with dementia, and has asked providers to review their treatment plans. The purpose of this systematic PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)-based review was to summarize original research studies on facility level characteristics contributing to the use of antipsychotics in nursing homes across the United States, in order to investigate the variation of use.

methodsWe searched Ovid Medline, Embase, Cochrane Library, Web of Science, CINAHL, PsycInfo, and Sociological Abstracts. Articles were selected according to the following criteria: (1) Population of interest: older adults (≥60 years of age) residing in nursing homes (not home-based or inpatient hospital settings) in the U.S. (2) Receiving APMs, typical and/or atypical. Specifically excluded were studies of psychotropic medications such as antidepressants, benzodiazepines, anxiolytics, hypnotics, mood stabilizers, and stimulants. All study designs were considered, though reviews, editorials, letters to the editor and opinion pieces were excluded. An expert consultant panel was consulted to categorize facility characteristics into domains and determine possible etiologies of APM use based upon each characteristic.

resultsNineteen observational studies, both quantitative and qualitative, published from 2000 to 2015, met full inclusion criteria and were included in this review. APM use varied based on multiple facility characteristics across several domains: 1) physical, 2) staffing, 3) occupancy, 4) market, and 5) quality.

conclusionsVariation in use of APMs in U.S. nursing homes based upon facility characteristics exemplifies the need for a more systematic protocol guiding the use of these medications, along with heightened regulatory policies and enforcement.

Indexed as

DementiaAgedAntipsychotic AgentsHomes for the AgedHumansMedication Therapy ManagementNursing HomesPractice Patterns, Physicians'United StatesAntipsychotic AgentsAntipsychoticsBehavioral symptomsDementiaNursing homes

Identifiers

PMID28122506
PMCPMC5267409
OpenAlexW2582628548

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.