Evidence map›Paper›PMID 38924586›Full record

ArticlePsychogeriatrics : the official journal of the Japanese Psychogeriatric Society2024

Lessons learned from CMS's National Partnership to Improve Dementia Care: a thematic synthesis of multiple stakeholder-engaged studies.

Jonathan D Winter, J William Kerns, Katherine M Winter, Christopher Winter, Alex Krist, Rebecca S Etz

Abstract read
In one paragraph

Article in Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 2024. 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
–field-weighted citation impact
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.

  1. Article
  2. A National Survey of Nursing Home Clinicians to Explain Increased Valproate Prescribing.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025
    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.

Jonathan D WinterVCU-Shenandoah Family Practice Residency, Front Royal, Virginia, USA.ORCID https://orcid.org/0000-0001-8650-5066
J William KernsVCU-Shenandoah Family Practice Residency, Front Royal, Virginia, USA.
Katherine M WinterVCU-Shenandoah Family Practice Residency, Front Royal, Virginia, USA.
Christopher WinterDepartment of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA.
Alex KristDepartment of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA.
Rebecca S EtzDepartment of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA.

Funding

Prescribing trends and associated outcomes of antiepileptic drugs and other psychoactive medications in US nursing homes surrounding the COVID-19 pandemicR01AG074358 · NIA · VIRGINIA COMMONWEALTH UNIVERSITY · PI Jonathan David Winter · 2022 to 2026
$3.6M
NIA NIH HHS R01 AG074358
6 · The paper itself

Abstract

backgroundAntipsychotic prescribing in United States nursing homes (NHs) has decreased since the Center for Medicare & Medicaid Service debuted the National Partnership to Improve Dementia Care in Nursing Homes (NP); however, reductions have stalled. To help explain persistent antipsychotic use despite the NP's reduction efforts, the perspectives of diverse NP stakeholders were qualitatively assessed. This study aimed to re-evaluate these individual perspectives in combined thematic synthesis to discover NP improvement opportunities undetectable in single stakeholder assessments.

methodsThematic synthesis. Through immersive crystallisation, original source coding results were organised into related descriptive themes. Similarities and differences were identified, and descriptive themes were regrouped into new, increasingly abstract, analytical themes. This cycle continued until variances were resolved and analytic themes sufficiently described and explained all initial descriptive themes.

resultsThree analytic themes emerged regarding NP improvement opportunities. The NP's positive impacts would be augmented by: (i) a deeper and expanded appreciation of stakeholder perspectives; (ii) more urgent and rapid adaptation to unintended adverse outcomes; and (iii) greater recognition of the contextual and environmental factors influencing decisions to prescribe or not prescribe antipsychotic medications. Stakeholder groups described: perspectives they perceived as inadequately considered by the NP; insufficient NP engagement with the stakeholders capable of creating evidenced, affordable, and available non-pharmacologic therapies for dementia symptoms; recognition that dementia interventions effective for a specific individual at a specific time in a specific community may not generalise; and diverse ongoing undesirable outcomes from NP policies that could be mitigated by NP modifications.

conclusionsThe NP has done much to advance dementia care in NHs. Notwithstanding, these results suggest the NP would only be improved through increasingly comprehensive inclusion of stakeholder perspectives, enhanced incorporation of individual contextual factors, and a more decisive mechanism for ongoing and continual adaptation.

Indexed as

Antipsychotic AgentsCenters for Medicare and Medicaid Services, U.S.DementiaNursing HomesStakeholder ParticipationAgedHomes for the AgedHumansQuality ImprovementUnited StatesAntipsychotic AgentsantipsychoticdementiaNational Partnershipnursing home

Identifiers

PMID38924586
PMCPMC11368649

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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.