Evidence map›Paper›PMID 30061102›Full record

ArticleBMJ quality & safety2019

Public reporting of antipsychotic prescribing in nursing homes: population-based interrupted time series analyses.

Noah M Ivers, Monica Taljaard, Vasily Giannakeas, Catherine Reis, Evelyn Williams, Susan Bronskill

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

Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

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  14. Pharmacological Management of Neuropsychiatric Symptoms of Dementia.Current treatment options in psychiatry · 2020
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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

6 authors at 5 institutions in 1 country.

Noah M IversWomen's College Research Institute and Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.
Monica TaljaardClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Vasily GiannakeasWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Catherine ReisWomen's College Research Institute and Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.
Evelyn WilliamsDivision of Long Term Care, Sunnybrook Health Science Centre, Toronto, Ontario, Canada.
Susan BronskillInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Women's College Hospital · CAInstitute for Clinical Evaluative Sciences · CAOttawa Hospital Research InstituteSunnybrook Health Science Centre · CAUniversity of Toronto · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundAlthough sometimes appropriate, antipsychotic medications are associated with increased risk of significant adverse events. In 2014, a series of newspaper articles describing high prescribing rates in nursing homes in Ontario, Canada, garnered substantial interest. Subsequently, an online public reporting initiative with home-level data was launched. We examined the impact of these public reporting interventions on antipsychotic prescribing in nursing homes.

methodsTime series analysis of all nursing home residents in Ontario, Canada, between 1 October 2013 and 31 March 2016. The primary outcome was the proportion of residents prescribed antipsychotics each month. Balance measures were prescriptions for common alternative sedating agents (benzodiazepines and/or trazodone). We used segmented regression to assess the effects on prescription trends of the newspaper articles and the online home-level public reporting initiative.

resultsWe included 120 009 nursing home resident admissions across 636 nursing homes. Following the newspaper articles, the proportion of residents prescribed an antipsychotic decreased by 1.28% (95% CI 1.08% to 1.48%) and continued to decrease at a rate of 0.2% per month (95% CI 0.16% to 0.24%). The online public reporting initiative did not alter this trend. Over 3 years, there was a net absolute reduction in antipsychotic prescribing of 6.0% (95% CI 5.1% to 6.9%). Trends for benzodiazepine prescribing did not change as substantially during the period of observation. Trazodone use has been gradually increasing, but its use did not change abruptly at the time of the mass media report or the public reporting initiative.

interpretationThe rapid impact of mass media on prescribing suggests both an opportunity to use this approach to invoke change and a warning to ensure that such reporting occurs responsibly.

Indexed as

AgedAged, 80 and overAntipsychotic AgentsDrug UtilizationFemaleHomes for the AgedHumansHypnotics and SedativesInterrupted Time Series AnalysisMaleNursing HomesOntarioSex FactorsAntipsychotic AgentsHypnotics and Sedativesantipsychotic prescribinginterrupted time seriesnursing homespublic reporting interventions

Identifiers

PMID30061102
PMCPMC6373421
OpenAlexW2886251977

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.