Evidence map›Paper›PMID 34762846›Full record

ArticleJournal of the American Medical Directors Association2022

Melatonin Prescribing in Assisted Living.

Punita Peketi, Sheryl Zimmerman, Stephanie Palmertree, Christopher J Wretman, John S Preisser, Philip D Sloane

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

Article in Journal of the American Medical Directors Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Dementia and COVID-19 infection control in assisted living in seven states.Journal of the American Geriatrics Society · 2022
    Article
  2. Review
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 2 institutions in 1 country.

Punita PeketiNortheast Ohio Medical University, Rootstown, OH, USA.
Sheryl ZimmermanThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: Sheryl_Zimmerman@unc.edu.
Stephanie PalmertreeThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Christopher J WretmanThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
John S PreisserGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Philip D SloaneThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill · USNortheast Ohio Medical University · US

Funding

Addressing Behavior and Mood in Assisted Living: Organizational Characteristics Related to the Use of Antipsychotic and Psychotropic Medications and Alternative PracticesR01AG050602 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ZIMMERMAN, SHERYL · 2015 to 2019
$3.9M
UNC-CH Summer Research Training in Aging for Medical StudentsT35AG038047 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JAN BUSBY-WHITEHEAD · 2010 to 2026
$1.4M
NIA NIH HHS R01 AG050602NIA NIH HHS T35 AG038047
6 · The paper itself

Abstract

objectivesAging is associated with sleep problems, which are common among assisted living (AL) residents. More than 40% of residents have insomnia, and almost 70% have a sleep disturbance of some kind. Melatonin to treat sleep disorders has become common among older adults, but its use in AL is unknown, which is concerning because melatonin may have side effects and interfere with other medications. The purpose of this study was to determine the prevalence and correlates of melatonin prescribing in AL, to inform whether changes in care may be indicated.

designCross-sectional chart abstracts and interviews. SETTINGS AND

participantsData were collected in 250 randomly selected AL communities among 5777 residents across 7 states in the United States and weighted to an estimated 4043 communities and 152,719 residents.

methodsCharts of residents were abstracted, and AL administrators and health care supervisors were interviewed to obtain information related to case-mix, staffing, and attitudes regarding psychoactive medications. Weighted analyses primarily examined the association of melatonin prescribing with community- and resident-level characteristics.

resultsMelatonin was prescribed in 82% of communities, more commonly in those that had a registered nurse or licensed practical nurse on site (+7%, P = .027), and whose health care supervisor was more favorable toward nonpharmacologic practices (+18%, P = .010). On average, 9% of residents were prescribed melatonin, with prescriptions being more common among those diagnosed with dementia (+24%, P = .004); a psychiatric disorder, especially an anxiety disorder (+43%, P = .007); having behavioral expressions; and taking other psychotropics. Coprescribing was common, especially with antidepressants (OR 2.64, 95% CI 1.99, 3.48; P < .001). CONCLUSIONS AND IMPLICATIONS: This study is the first to examine melatonin prescribing in AL, and finds it to be common. Such use may be appropriate if it is as a more suitable replacement for hypnotics. The fact that use varies by organizational characteristics suggests practices may be modifiable. Research examining benefits and side effects of melatonin, overall and in relation to other medications, is indicated to promote better care for AL residents.

Indexed as

MelatoninAgedAntidepressive AgentsCross-Sectional StudiesDelivery of Health CareHumansPsychotropic DrugsUnited StatesAntidepressive AgentsMelatoninPsychotropic DrugsAssisted livingmedicationprescribing

Identifiers

PMID34762846
PMCPMC9097337
OpenAlexW3211951141

What OpenQuestion holds

Textmetadata
LicenceTDM
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.