ArticleJournal of the American Medical Directors Association2023
Factors Associated With Benzodiazepine and Antipsychotic Prescribing in Hospice: A Qualitative Study of Hospice Prescribers.
Article in Journal of the American Medical Directors Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Hospice Clinicians' Approaches to Terminal Restlessness: A Qualitative Analysis.Journal of pain and symptom management · 2026Article
- Unintended Consequences of Federal Initiatives on Antipsychotic Prescribing in Hospice.Journal of general internal medicine · 2026Article
- Benzodiazepine or Antipsychotic Use and Mortality Risk Among Patients With Dementia in Hospice Care.JAMA network open · 2025Article
- Behavioral symptoms and treatment challenges for patients living with dementia: Hospice clinician and caregiver perspectives.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesBenzodiazepine and antipsychotic medications are common components of the hospice toolkit and are routinely prescribed for behavioral symptom management at end of life. These medications have significant associated risks but, despite their frequent use, little is known about how clinicians weigh prescribing decisions for individuals in hospice. In this qualitative study, we examined the key factors that influence the decision to initiate a benzodiazepine and antipsychotic medication for management of behavioral symptoms at end of life.
designA qualitative study using semi-structured interviews and descriptive qualitative analysis. SETTING AND
participantsWe conducted semi-structured interviews with prescribing hospice physicians and nurse practitioners working in hospice settings across the United States.
methodsHospice clinicians were asked to describe factors that influence prescribing decisions to initiate benzodiazepine and antipsychotic medications for the management of behavioral symptoms. Data from audio-recorded sessions were transcribed, coded to identify relevant concepts, and reduced to determine major themes.
resultsWe completed 23 interviews with hospice physicians and nurse practitioners. On average, participants had worked in a hospice setting for a mean of 14.3 years (SD: 10.9); 39% had geriatrics training. Major themes related to benzodiazepine and antipsychotic prescribing were (1) caregiving factors strongly influence the use of medications, (2) patient and caregiver stigma and concerns regarding medication use limit prescribing, (3) medications are initiated to avoid hospitalization or transition to a higher level of care, and (4) nursing home hospice care brings unique challenges. CONCLUSION AND IMPLICATIONS: Caregiver factors and the setting of hospice care strongly influence clinician decisions to initiate benzodiazepines and antipsychotics in hospice. Caregiver education about medication use at end of life and support in managing challenging behaviors may help promote optimal prescribing.
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