Abstract
The Centers for Medicare and Medicaid Services' National Partnership to Improve Dementia Care in Nursing Homes focuses on but is not limited to long-term care (LTC) residents with dementia; the potential impact on residents with other diagnoses is unclear. We sought to determine whether resident subpopulations experienced changes in antipsychotic and mood stabilizer prescribing. Repeated cross-sectional analysis of a 20% Medicare sample, 2011-2014. Fee-for-service Medicare beneficiaries with Part D coverage in LTC (n = 562,485) and a secondary analysis limited to persons with depression or bipolar disorder (n = 139,071). Main outcome was quarterly predicted probability of treatment with an antipsychotic or mood stabilizer. From 2011 to 2014, the adjusted predicted probability (APP) of antipsychotic treatment fell from 0.120 [95% confidence interval (CI) 0.119-0.121] to 0.100 (95% CI 0.099-0.101; P < .001). Use decreased for all age, sex, and racial/ethnic groups; the decline was larger for persons with dementia (P < .001). The APP of mood stabilizer use grew from 0.140 (95% CI 0.139-0.141) to 0.185 (95% CI 0.184-0.186), growth slightly larger among persons without dementia (P < .001). Among persons with depression or bipolar di...Continue Reading
References
Sep 1, 1992·Journal of the American Geriatrics Society·R Elon, L G Pawlson
Jan 1, 1995·The Journal of Neuropsychiatry and Clinical Neurosciences·A D LottM A Keys
Oct 1, 1995·Journal of Geriatric Psychiatry and Neurology·P N TariotI R Katz
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Feb 1, 2000·Journal of Clinical Psychopharmacology·N HerrmannM Myszak
Dec 29, 2000·The Gerontologist·J MagazinerS Kittner
Mar 29, 2002·International Journal of Geriatric Psychiatry·Jennifer L PayneConstantine G Lyketsos
May 5, 2009·General Hospital Psychiatry·John W WilliamsLynn Whitener
May 6, 2009·Health Affairs·David C GrabowskiVincent Mor
Sep 29, 2011·JAMA : the Journal of the American Medical Association·Alicia Ruelaz MaherPaul G Shekelle
Dec 24, 2011·The American Journal of Psychiatry·Helen C KalesFrederic C Blow
Mar 1, 2012·BMJ : British Medical Journal·K F HuybrechtsS Schneeweiss
Feb 7, 2013·JAMA : the Journal of the American Medical Association·Becky A BriesacherJerry H Gurwitz
Jun 21, 2013·International Psychogeriatrics·Maria GustafssonHugo Lövheim
Mar 4, 2015·BMJ : British Medical Journal·Helen C KalesConstantine G Lyketsos
Nov 4, 2015·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Akshya VasudevMuhammad Mamdani
Jan 13, 2017·Aging & Mental Health·Brianne L Olivieri-MuiBecky Briesacher
Jul 21, 2017·Aging & Mental Health·Claudia H W SmeetsRaymond T C M Koopmans
Aug 3, 2017·The New England Journal of Medicine·Christopher W Goodman, Allan S Brett
Jan 4, 2018·JAMA Internal Medicine·Michael E Johansen
Mar 1, 2018·The Australian and New Zealand Journal of Psychiatry·Juanita WestburyGregory Peterson
Mar 20, 2018·JAMA Internal Medicine·Donovan T MaustHelen C Kales
Aug 1, 2018·BMJ Quality & Safety·Noah M IversSusan Bronskill
Mar 23, 2019·JAMA Network Open·Ismaeel YunusaTewodros Eguale
Mar 26, 2019·JAMA Internal Medicine·Christopher W Goodman, Allan S Brett