Organizational Factors Associated With Inappropriate Neuroleptic Drug Prescribing in Nursing Homes: A Multilevel Approach

Journal of the American Medical Directors Association
Clarisse Laffon de MazièresYves Rolland

Abstract

To determine whether the number of attending general practitioners (GPs) in nursing homes and other facility characteristics are associated with inappropriate neuroleptic prescribing. Cross-sectional study. One hundred seventy-five nursing homes in France participating in the IQUARE (Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en EHPAD) study. A total of 6275 residents included between May and July 2011. The outcome measure was potentially inappropriate prescribing of neuroleptic drugs according to the approved indications and French guidelines. Resident characteristics and nursing home characteristics were electronically recorded by the nursing home's coordinating physician. Because of the hierarchical structure of data (resident level and nursing home level), multivariate analysis using a multilevel binary logistic model was carried out to investigate factors associated with inappropriate neuroleptic prescribing. Of 6275 residents enrolled, 1532 (24.4%) had at least 1 prescription for a neuroleptic drug. This corresponded to 513 residents (33.5%) with appropriate prescribing (with regard to indication, substance and dose) and 1019 (66.5%) with potentially inappropriate pr...Continue Reading

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Citations

Jan 26, 2016·Journal of the American Medical Directors Association·Anna-Liisa JuolaKaisu H Pitkälä
Jan 28, 2017·Journal of the American Medical Directors Association·Clarisse Laffon de MazièresYves Rolland
Apr 3, 2018·British Journal of Clinical Pharmacology·Charlène CoolMaryse Lapeyre-Mestre
Oct 4, 2018·American Journal of Alzheimer's Disease and Other Dementias·Mathieu MaltaisPhilipe de Souto Barreto
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Sep 22, 2017·International Psychogeriatrics·Klaas van der SpekDebby L Gerritsen
Jul 30, 2016·International Psychogeriatrics·Sarah I M JanusSytse U Zuidema
Aug 28, 2019·Journal of Clinical Medicine·Syed Shahzad HasanZaheer-Ud-Din Babar
Nov 26, 2018·Journal of the American Medical Directors Association·Vincent GuionYves Rolland
May 28, 2019·Journal of the American Medical Directors Association·Roger Y Wong, Paul R Katz

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