ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2026
Impact of national partnership to improve dementia care on antipsychotic use duration for dementia residents in nursing homes.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFederal policies have successfully targeted the prevalence of antipsychotic (AP) exposure in NHs, but the duration of treatment among nursing home (NH) residents has not been reported. We evaluated AP duration and discontinuation within six months in residents with dementia.
methodsRetrospective cohort study of long-stay NH residents with dementia who newly initiated an AP medication. We evaluated changes in AP duration and discontinuation within six months relative to two federal initiatives: National Partnership to Improve Dementia Care (2012) and inclusion of AP use measures in the NH Star Ratings (2015). We accounted for resident and facility characteristics in a competing-risks analysis establishing the relationship between the two policy periods and AP outcomes.
resultsThere were 43 668 new episodes of AP initiation among 38 275 residents. The duration of treatment within six months declined from 125.9 days in the pre-Partnership period to 120.5 days and 120.6 days in the post-Partnership and post-Five Star periods, respectively. Those who initiated APs after the Partnership [adjusted hazard ratio (aHR) = 1.17; confidence interval, 1.10-1.24] and after the Five Star Rating change (aHR = 1.19; 95% CI, 1.07-1.32) policy periods were more likely to stop the medication within 6 months as compared to those who initiated during the prior period.
conclusionsFederal policies designed to reduce AP prescribing in NH residents with dementia had a nominal impact on treatment duration within the first six months, with more than half continuing treatment beyond 6 months.
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