ArticleJournal of the American Geriatrics Society2025
Association of nursing home antipsychotic reduction policies with antipsychotic use in community dwellers with dementia.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 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.
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.
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Who cites it
6 citing papers in PubMed.
- Implementing antipsychotic reduction in long-term care: interdisciplinary and lived-experience insights into system-level barriers and facilitators.The Gerontologist · 2026Article
- A Comprehensive Simulation Study to Evaluate the Effect Size and Study Length Relationship in Single-Group Interrupted Time Series Analysis.Evaluation & the health professions · 2026Article
- Barriers and facilitators to implementing strategies for reducing inappropriate antipsychotic use in long-term care: a scoping review.BMC geriatrics · 2026Article
- Receipt of Medicare Part D comprehensive medication reviews in older adults with dementia.Journal of managed care & specialty pharmacy · 2025Article
- Trends in antipsychotic prescribing among community-dwelling older adults with dementia, 2010-2018.Health affairs scholar · 2025Article
- Association of nursing home antipsychotic reduction policies with antipsychotic use in community dwellers with dementia.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundAntipsychotic and other psychotropic medication use is prevalent among community-dwelling older adults with dementia despite the potential for adverse effects. Two Centers for Medicare & Medicaid Services (CMS) initiatives, the National Partnership to Improve Dementia Care ("the Partnership") and the Five Star Quality Rating System for antipsychotic use reporting, have been successful in reducing antipsychotic use in nursing home residents. We assessed if these initiatives had a spillover effect in antipsychotic and other psychotropic medication use among community dwellers with dementia due to potential overlap in prescribers across settings.
methodsAmong community-dwelling older adults with dementia, we examined psychotropic medication class use (i.e., antipsychotics, antidepressants, anxiolytics, anticonvulsants/mood stabilizers, antidementia) in 2010-2017 Medicare fee-for-service claims using interrupted time series analyses across three periods ("Pre-Partnership": July 1, 2010 to March 31, 2012; "Post-Partnership": April 1, 2012 to January 31, 2015; "Five Star Quality Rating": February 1, 2015 to December 31, 2017).
resultsWe included 1,289,401 community dwellers with dementia contributing 26,609,697 person-months. The mean age was 80 years, most were female (70%), approximately 80% were non-Hispanic Whites, 10% were non-Hispanic Blacks, and 5% were Hispanic ethnicity. Antipsychotic use was declining pre-Partnership (β = -0.06, 95% CI: -0.08, -0.05) and post-Partnership (β = -0.02, 95% CI: -0.02, -0.01). Post-Five Star Quality Rating, antipsychotic use remained stable with a nearly flat slope (β = -0.01, 95% CI: -0.01, 0.00). Anticonvulsant and antidepressant use increased and anxiolytic and antidementia medication use decreased among community-dwelling older adults with dementia.
conclusionsThese two CMS policies on antipsychotic use for nursing home residents were not associated with a spillover effect to community-dwelling older adults with dementia. Strategies to monitor the appropriateness of psychotropic medication use may be warranted for community-dwellers with dementia.
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