ArticleJournal of the American Medical Directors Association2021
Deprescribing Blood Pressure Treatment in Long-Term Care Residents.
Article in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- Sociodemographic differences in discontinuation of high-risk medications: a retrospective cohort study.npj aging · 2025Article
- Hypertension Treatment, Blood Pressure, and Deprescribing Among US Nursing Home Residents With and Without Dementia Before and After the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2025Article
- Antihypertensive Deprescribing and Functional Status in VA Long-Term Care Residents With and Without Dementia.Journal of the American Geriatrics Society · 2025Article
- Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents.JAMA network open · 2024Observational
- Challenging the status quo: deprescribing antihypertensive medication in older adults in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Complex Patterns of Antihypertensive Treatment Changes in Long-Term Care Residents.Journal of the American Medical Directors Association · 2024Article
- The state of deprescribing research: How did we get here?Basic & clinical pharmacology & toxicology · 2023Article
- Optimizing pharmacotherapy and deprescribing strategies in older adults living with multimorbidity and polypharmacy: EuGMS SIG on pharmacology position paper.European geriatric medicine · 2023Article
- Prescriber Perspectives and Experiences with Deprescribing Versus Continuing Bisphosphonates in Older Nursing Home Residents with Dementia.Journal of general internal medicine · 2023Article
- Deprescribing research in nursing home residents using routinely collected healthcare data: a conceptual framework.BMC geriatrics · 2023Review
- Systolic blood pressure, antihypertensive treatment, and cardiovascular and mortality risk in VA nursing home residents.Journal of the American Geriatrics Society · 2023Article
- Antihypertensive Deprescribing in Older Adults: a Practical Guide.Current hypertension reports · 2022Review
- Medicines use before and after comprehensive medicines review among residents of long-term care facilities: a retrospective cohort study.BMC geriatrics · 2022Article
- Association of Antihypertensives and Cognitive Impairment in Long-Term Care Residents.Journal of Alzheimer's disease : JAD · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo evaluate the incidence of deprescribing of antihypertensive medication among older adults residing in Veterans Affairs (VA) nursing homes for long-term care and rates of deprescribing after potentially triggering events.
designRetrospective cohort study. SETTING AND
participantsLong-term care residents aged 65 years and older admitted to a VA nursing home from 2006 to 2019 and using blood pressure medication at admission.
methodsData were extracted from the VA electronic health record, and Centers for Medicare & Medicaid Services Minimum Data Set and Bar Code Medication Administration. Deprescribing was defined on a rolling basis as a reduction in the number or dose of antihypertensive medications, sustained for ≥2 weeks. We examined potentially triggering events for deprescribing, including low blood pressure (<90/60 mmHg), acute renal impairment (creatinine increase of 50%), electrolyte imbalance (potassium below 3.5 mEq/L, sodium decrease by 5 mEq/L), and falls.
resultsAmong 31,499 VA nursing home residents on antihypertensive medication, 70.4% had ≥1 deprescribing event (median length of stay = 6 months), and 48.7% had a net reduction in antihypertensive medications over their stay. Deprescribing events were most common in the first 4 weeks after admission and the last 4 weeks of life. Among potentially triggering events, a 50% increase in serum creatinine was associated with the greatest increase in the likelihood of deprescribing over the subsequent 4 weeks: residents with this event had a 41.7% chance of being deprescribed compared with 11.5% in those who did not (risk difference = 30.3%, P < .001). A fall in the past 30 days was associated with the smallest magnitude increased risk of deprescribing (risk difference = 3.8%, P < .001) of the events considered. CONCLUSIONS AND IMPLICATIONS: Deprescribing of antihypertensive medications is common among VA nursing home residents, especially after a potential renal adverse event.
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Registered trials
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