Evidence map›Paper›PMID 35775444›Full record

ArticleJournal of the American Geriatrics Society2022

Benzodiazepine and antipsychotic use among hospitalized older adults before versus after restricting visitation: March to May 2020.

Rebecca T Brown, Kaitlyn Shultz, Jason Karlawish, Yi Zhou, Dawei Xie, Kira L Ryskina

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-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

6 citing papers in PubMed, 13 citations in OpenAlex.

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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.

Rebecca T BrownDivision of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-7483-4137
Kaitlyn ShultzDivision of General Internal Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jason KarlawishDivision of Geriatric Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Yi ZhouPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Dawei XieDepartment of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kira L RyskinaLeonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
University of Pennsylvania · USPhiladelphia VA Medical Center · US

Funding

Post-acute care of older adults: the role of skilled nursing facility specialistsR01AG066841 · NIA · UNIVERSITY OF PENNSYLVANIA · PI RYSKINA, KIRA L · 2020 to 2024
$2.0M
Improving Aging in Place for Older Adults Living in Subsidized HousingK76AG057016 · NIA · UNIVERSITY OF PENNSYLVANIA · PI BROWN, REBECCA TYLER · 2018 to 2020
$853k
UNDERSTANDING THE ROLE OF PHYSICIAN INTEGRATION WITHIN NURSING HOMES IN POST-ACUTE CARE OUTCOMESK08AG052572 · NIA · UNIVERSITY OF PENNSYLVANIA · PI RYSKINA, KIRA L · 2016 to 2020
$821k
NIA NIH HHS K08 AG052572NIA NIH HHS K76 AG057016NIA NIH HHS R01 AG066841
6 · The paper itself

Abstract

backgroundHospital visitation restrictions during the COVID-19 pandemic prompted concerns about unintended consequences for older patients, including an increased incidence of delirium and agitation. While first-line interventions for these conditions are non-pharmacologic, a lack of family support could result in increased use of benzodiazepines and antipsychotics, which are associated with poor outcomes in older adults. Little is known about the association of visitation policies with use of these medications among older adults.

methodsWe conducted a retrospective cross-sectional study among adults aged ≥65 hospitalized from March 1 through May 31, 2020 at four hospitals in the Mid-Atlantic. The dates of onset of visitation restrictions (i.e., hospital-wide guidelines barring visitors) were collected from hospital administrators. Outcomes were use of benzodiazepines and antipsychotics, assessed using patient-level electronic health record data. Using multivariable logistic regression with hospital and study-day fixed effects, the quasi-experimental study design leveraged the staggered onset of visitation restrictions across the hospitals to measure the odds of receiving each medication when visitors were versus were not allowed.

resultsAmong 2931 patients, mean age was 76.6 years (SD, 8.3), 51.6% were female, 58.6% white, 32.5% black, and 2.6% Hispanic. Overall, 924 (31.5%) patients received a benzodiazepine and 298 (10.2%) an antipsychotic. The adjusted odds of benzodiazepine use was lower on days when visitors were versus were not allowed (adjusted odds ratio [AOR], 0.62; 95% CI, 0.39, 0.99). Antipsychotic use did not significantly differ between days when visitors were versus were not allowed (AOR, 0.98; 95% CI, 0.43, 2.21).

conclusionsAmong older patients hospitalized during the first wave of the pandemic, benzodiazepine use was lower on days when visitors were allowed. These findings suggest that the presence of caregivers impacts use of potentially inappropriate medications among hospitalized older adults, supporting efforts to recognize caregivers as essential members of the care team.

Indexed as

Antipsychotic AgentsCOVID-19 Drug TreatmentAgedBenzodiazepinesCross-Sectional StudiesFemaleHumansMalePandemicsRetrospective StudiesAntipsychotic AgentsBenzodiazepinesacute care hospitalsolder adultspotentially inappropriate medicationsvisitation restrictions

Identifiers

PMID35775444
PMCPMC9588494
OpenAlexW4283749587

What OpenQuestion holds

Textmetadata
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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.