Evidence map›Paper›PMID 32798337›Full record

ArticleJournal of the American Geriatrics Society2020

Decrease of Anticholinergic Drug Use in Nursing Home Residents in the United States, 2009 to 2017.

Ioannis Malagaris, Hemalkumar B Mehta, Shuang Li, James S Goodwin

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 17% 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

8 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Association Between State Essential Caregiver Programs and Antipsychotic Medication Use Rate in Nursing Homes During the COVID-19 Pandemic.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026
    Article
  5. Article
  6. Article
  7. Trends and variation in benzodiazepine use in nursing homes in the USA.European journal of clinical pharmacology · 2022
    Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Ioannis MalagarisSealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas.ORCID 0000-0001-5126-2068
Hemalkumar B MehtaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Shuang LiSealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas.
James S GoodwinSealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas.ORCID 0000-0003-0704-2214
The University of Texas Medical Branch at Galveston · USJohns Hopkins University · US

Funding

UTMB OAIC Research Education Component (REC)P30AG024832 · NIA · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI JAMES S. GOODWIN, MD, MELISSA M. MORROW · 2005 to 2026
$26.7M
Established Investigator Award in Cancer Prevention & ControlK05CA134923 · NCI · UNIVERSITY OF TEXAS MED BR GALVESTON · PI GOODWIN, MD, JAMES S. · 2008 to 2019
$1.0M
NCI NIH HHS K05 CA134923NCI NIH HHS K05-CA134923NIA NIH HHS P30 AG024832NIH HHS P30-AG024832-12
6 · The paper itself

Abstract

objectiveTo investigate the time course of anticholinergic drug use in nursing home residents and assess if any temporal change in anticholinergic use varied by nursing home quality rating.

designRetrospective repeated cross-sectional analysis of Medicare enrollment, Parts A, B, and D, claims data linked to the Minimum Data Set from 2009 to 2017.

settingMedicare-certified nursing homes.

participantsLong-term residents 65 years or older with nursing home stay of at least 100 consecutive days within a given calendar year. MEASUREMENTS: Estimates of anticholinergic drug prescription rates between 2009 and 2017 were based on a binary variable indicating whether a resident received a drug with high anticholinergic activity, as defined by the Anticholinergic Cognitive Burden scale, for at least 1 day during the initial 100 consecutive days of nursing home stay in a given calendar year. We used mixed effects logistic regression models to determine adjusted rates of anticholinergic use each year and test the interaction between nursing home quality rating and year, while adjusting for patient and nursing home characteristics.

resultsThe cohort included 786,858 100-day nursing home stays (299,354 unique residents) in 6,703 nursing homes for the years 2009 to 2017. Prescription rates were stable at approximately 34% to 35% between 2009 and 2011, then gradually decreased to 24.3% in 2017 (P < .0001), with the decline being more pronounced in nursing homes having high quality ratings (P < .0001). Rates for anticholinergic drugs in nursing homes with 4 to 5 star quality rating (33.7% in 2011 to 23.3% in 2017) showed a steeper decline over time relative to nursing homes with 1 to 2 star quality rating (34.2% in 2011 to 25.2% in 2017) (P < .0001).

conclusionsThe use of drugs with high anticholinergic activity has declined from 2009 to 2017, with a greater decline in higher-quality nursing homes.

Indexed as

DeprescriptionsAgedAged, 80 and overCholinergic AntagonistsCross-Sectional StudiesDrug PrescriptionsFemaleHumansMaleMedicareNursing HomesRetrospective StudiesTime FactorsUnited StatesCholinergic Antagonistsanticholinergic drug useantipsychoticsnursing homes

Identifiers

PMID32798337
PMCPMC8285038
OpenAlexW3049580569

What OpenQuestion holds

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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.