Evidence map›Paper›PMID 34919835›Full record

ArticleJournal of the American Medical Directors Association2022

As-Needed Prescribing and Administration of Psychotropic Medications in Assisted Living: A 7-State Study.

Paula Carder, Sheryl Zimmerman, Christopher J Wretman, John S Preisser, Sarah Dys, 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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 29% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025
    Article
  3. Article
  4. Article
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.

Paula CarderInstitute on Aging, College of Urban and Public Affairs, Portland State University, Portland, OR, USA; School of Public Health, Oregon Health and Science University-Portland State University, Portland, OR, USA. Electronic address: pdx03498@pdx.edu.
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.
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.
Sarah DysInstitute on Aging, College of Urban and Public Affairs, Portland State University, Portland, OR, USA; School of Public Health, Oregon Health and Science University-Portland State University, Portland, OR, 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 · USPortland State 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
NIA NIH HHS R01 AG050602
6 · The paper itself

Abstract

objectivesPsychotropic medications administered on an as-needed basis, often designated as pro re nata (or PRN, hereafter as-needed), can alleviate acute symptoms and facilitate deprescribing, although as-needed use is associated with negative outcomes such as polypharmacy and drug interactions. The aim of this study was to examine the extent to which PRN psychotropic medications are prescribed and administered to assisted living (AL) residents, overall and in relation to resident- and community-level characteristics.

designCross-sectional study. SETTING AND

participantsAll AL residents and select staff in 250 AL communities in 7 states.

methodsData regarding prescribing and administration of 5 types of PRN psychotropic medications in the prior 7 days (antipsychotics, mood stabilizers and antiepileptics, antidepressants, anxiolytics/hypnotics, and cognitive enhancers) were abstracted and compared across resident and community characteristics.

resultsPrescribing of PRN psychotropics in AL is low (10.3%). Of prescribed PRN medications, 2.5% of residents were administered a PRN and 8% had PRN that was not administered in the previous 7 days. Anxiolytics were administered PRN more commonly compared with antipsychotics (2.0% vs 0.2%). Of all PRN psychotropic prescriptions (n = 1039), 70.5% had a written indication describing the reason for administration. Among PRN medications administered (n = 242), the proportion with an indication was lower (62.0%). PRN psychotropic medication prescribing was higher among residents with dementia and a psychiatric diagnosis, and in larger AL communities and those with a higher proportion of dementia care beds. CONCLUSIONS AND IMPLICATIONS: The prescribing and administration of PRN psychotropic medications in AL is relatively rare, although more common among residents with dementia. Emerging psychotropic medication policies should be expanded to address mental health care, anxiolytic/hypnotic use for residents living with dementia, PRN prescribing in chart review, and the use of detailed indications for PRN use, especially when medications are administered by unlicensed care staff.

Indexed as

Anti-Anxiety AgentsAntipsychotic AgentsDementiaCross-Sectional StudiesHumansHypnotics and SedativesPharmaceutical PreparationsPsychotropic DrugsAnti-Anxiety AgentsAntipsychotic AgentsHypnotics and SedativesPharmaceutical PreparationsPsychotropic DrugsantipsychoticAssisted livingdementiapro re natapsychotropic

Identifiers

PMID34919835
PMCPMC9177506
OpenAlexW4200096701

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.