ArticleJournal of the American Geriatrics Society2023
Antipsychotic use among older patients with dementia receiving home health care services: Prevalence, predictors, and outcomes.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Stakeholder Perspectives on the Use of Telehealth to Support Deprescribing for Older Patients Transitioning From the Hospital to Home Health Care.Journal of the American Geriatrics Society · 2026Article
- Association Between State Essential Caregiver Programs and Antipsychotic Medication Use Rate in Nursing Homes During the COVID-19 Pandemic.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026Article
- Living alone with dementia is a neglected source of inequality: findings from a scoping review of research evidence.Systematic reviews · 2025Article
- Exploring Antipsychotic Initiation Among Persons Living With Dementia in a Comprehensive Dementia Care Program.Journal of the American Geriatrics Society · 2025Article
- Antipsychotic Use in Older Adults with Dementia: Community and Nursing Facility Trends in Texas, 2015-2020.Journal of the American Medical Directors Association · 2025Article
- Trends in antipsychotic prescribing among community-dwelling older adults with dementia, 2010-2018.Health affairs scholar · 2025Article
- Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review.Journal of the American Geriatrics Society · 2025Article
- Article
- Music to Their Ears: Reducing Antipsychotic Use With a Personalized Music Intervention for Rural Veterans.Cureus · 2024Article
- An integrative systematic review of nurses' involvement in medication deprescription in long-term healthcare settings for older people.Therapeutic advances in drug safety · 2024Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAntipsychotic use is a safety concern among older patients in home health care (HHC), particularly for those with Alzheimer's disease and related dementias (ADRD). The objective of this study was to examine the prevalence and predictors of antipsychotic use among older adults with and without ADRD who received HHC, and the association of antipsychotic use with outcomes among patients living with ADRD.
methodsIn this secondary analysis of adults ≥65 years receiving care from an HHC agency in New York in 2019 (N = 6684), we used data from the Outcome and Assessment Information Set, Medicare HHC claims, and home medication review results in the electronic HHC records during a 60-day HHC episode. ADRD was identified by diagnostic codes. Functional outcome was the change in the composite activities of daily living (ADL) score from HHC admission to HHC discharge (measured in 5833 patients), where a positive score means improvement and a negative score means decline. Data were analyzed using logistic (predictors) and linear regression (association with outcome) analyses.
resultsThe point prevalence of antipsychotic use was 17.2% and 6.6% among patients with and without ADRD, respectively. Among patients living with ADRD, predictors of antipsychotic use included having greater ADL limitations (odds ratio [OR] = 1.30, p = 0.01), taking more medications (OR = 1.04, p = 0.02), having behavioral and psychological symptoms (OR = 5.26, p = 0.002), and living alone (OR = 0.52, p = 0.06). Among patients living with ADRD, antipsychotic use was associated with having less ADL improvement at HHC discharge (β = -0.70, p < 0.001).
conclusionsHHC patients living with ADRD were more likely to use antipsychotics and to experience worse functional outcomes when using antipsychotics. Antipsychotics should be systematically reviewed and, if contraindicated or unnecessary, deprescribed. Efforts are needed to improve HHC patients' access to nonpharmacological interventions and to provide education for caregivers regarding behavioral approaches to manage symptoms in ADRD.
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