ArticleJournal of the American Medical Directors Association2020
Trends in Antipsychotic and Mood Stabilizer Prescribing in Long-Term Care in the U.S.: 2011-2014.
Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Bipolar Disorder and Manic-Like Symptoms in Alzheimer's, Vascular and Frontotemporal Dementia: A Systematic Review.Current neuropharmacology · 2023Pooled it
- Physician Antipsychotic Overprescribing Letters and Cognitive, Behavioral, and Physical Health Outcomes Among People With Dementia: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Pragmatic Trial of Personalized Music for Agitation and Antipsychotic Use in Nursing Home Residents With Dementia.Journal of the American Medical Directors Association · 2022Trial
- Study of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial.Lancet (London, England) · 2021Trial
- Patterns of Daily Administration of Psychoactive Drug Classes for Distress Behavior in Dementia.Journal of the American Medical Directors Association · 2026Article
- Predictors of a Gabapentinoid-Loop-Diuretic Prescribing Cascade in U.S. Nursing Home Residents.Journal of the American Geriatrics Society · 2026Article
- A National Survey of Nursing Home Clinicians to Explain Increased Valproate Prescribing.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- AI-based patient monitoring for fall prevention in stroke patients: a pilot study at a Malaysian acute stroke unit.Journal of neuroengineering and rehabilitation · 2025Article
- Clinician Perspectives on Increased Gabapentinoid Prescribing in Nursing Homes.Journal of the American Geriatrics Society · 2025Article
- Effects of Nursing Home Changes in Antipsychotic Use on Outcomes among Residents with Dementia.Journal of the American Medical Directors Association · 2025Observational
- A Nursing Home Clinician Survey to Explain Gabapentinoid Increases.Journal of the American Medical Directors Association · 2025Article
- Association of nursing home antipsychotic reduction policies with antipsychotic use in community dwellers with dementia.Journal of the American Geriatrics Society · 2025Article
- Prescribing Trends and Associated Outcomes of Antiepileptic Drugs and Other Psychotropic Medications in US Nursing Homes: Proposal for a Mixed Methods Investigation.JMIR research protocols · 2024Article
- Lessons learned from CMS's National Partnership to Improve Dementia Care: a thematic synthesis of multiple stakeholder-engaged studies.Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · 2024Article
- Federal Nursing Home Policies on Antipsychotics had Similar Impacts by Race and Ethnicity for Residents With Dementia.Journal of the American Medical Directors Association · 2023Article
- Trends in Antiseizure Medication Prescribing Among Nursing Home Residents With and Without a Seizure Diagnosis.The neurologist · 2023Article
- Nursing Homes Underreport Antipsychotic Use but Overreport Diagnoses Qualifying for Appropriate Use.Health affairs scholar · 2023Article
- Long-Stay Mood Stabilizer Use Increasing as Prescription of Antipsychotics Decreases.GeroPsych · 2023Article
- Comparative Risk of Harm Associated with Zopiclone or Trazodone Use in Nursing Home Residents: a Retrospective Cohort Study in Alberta, Canada.Canadian geriatrics journal : CGJ · 2023Article
- Antiepileptic prescribing to persons living with dementia residing in nursing homes: A tale of two indications.Journal of the American Geriatrics Society · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe Centers for Medicare and Medicaid Services' National Partnership to Improve Dementia Care in Nursing Homes focuses on but is not limited to long-term care (LTC) residents with dementia; the potential impact on residents with other diagnoses is unclear. We sought to determine whether resident subpopulations experienced changes in antipsychotic and mood stabilizer prescribing.
designRepeated cross-sectional analysis of a 20% Medicare sample, 2011-2014. SETTING AND PARTICIPANT: Fee-for-service Medicare beneficiaries with Part D coverage in LTC (n = 562,485) and a secondary analysis limited to persons with depression or bipolar disorder (n = 139,071).
methodsMain outcome was quarterly predicted probability of treatment with an antipsychotic or mood stabilizer.
resultsFrom 2011 to 2014, the adjusted predicted probability (APP) of antipsychotic treatment fell from 0.120 [95% confidence interval (CI) 0.119-0.121] to 0.100 (95% CI 0.099-0.101; P < .001). Use decreased for all age, sex, and racial/ethnic groups; the decline was larger for persons with dementia (P < .001). The APP of mood stabilizer use grew from 0.140 (95% CI 0.139-0.141) to 0.185 (95% CI 0.184-0.186), growth slightly larger among persons without dementia (P < .001). Among persons with depression or bipolar disorder, the APP of antipsychotic treatment increased from 0.081 (95% CI 0.079-0.082) to 0.087 (95% CI 0.085-0.088; P < .001); APP of mood stabilizer treatment grew more, from 0.193 (95% CI 0.190-0.196) to 0.251 (0.248-0.253; P < .001). Quetiapine was the most commonly prescribed antipsychotic. The most widely prescribed mood stabilizer was gabapentin, prescribed to 70.5% of those who received a mood stabilizer by the end of 2014. CONCLUSIONS AND IMPLICATIONS: The likelihood of antipsychotic and mood stabilizer treatment did not decline for residents with depression or bipolar disorder, for whom such prescribing may be appropriate but who were not excluded from the Partnership's antipsychotic quality measure. Growth in mood stabilizer use was widespread, and largely driven by growth in gabapentin prescribing.
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