Skip Navigation Archive: U.S. Department of Health and Human Services U.S. Department of Health and Human Services
Archive: Agency for Healthcare Research Quality www.ahrq.gov
Archival print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

  • Publication # 13-RA004

The March 2014 issue of Research Activities was the last issue of the monthly newsletter. AHRQ is transitioning to a new quarterly thematic publication that will provide longer, more in-depth analyses of individual topics related to AHRQ’s four priority areas. This new publication will be available online  in the Fall.

Research Activities readers will still be able to access published studies by AHRQ and AHRQ-supported researchers on the AHRQ Research Studies Web page, which will be online later this Spring. Studies can be accessed by first author, publication date, and key word.

Thanks to all our readers over the years who have told us how much they have enjoyed the newsletter. We hope our new quarterly publication will be equally useful in learning more about AHRQ and the field of health services research!

For questions, please contact Research Activities managing editor, Gail Makulowich, at gail.makulowich@ahrq.hhs.gov or at 301-427-1711.

Antipsychotic choices in nursing homes partly influenced by nursing home’s prescribing culture

Elderly Health/Long-Term Care

Between one-fifth and one-third of all nursing home patients receive antipsychotic medications. Their use continues to remain popular despite serious safety concerns. Today, nursing homes can select from older, conventional agents to newer, atypical ones. A new study reveals that the majority of nursing homes favor treating patients with atypical antipsychotics. Yet, patients and facility characteristics contribute partially to the medications selected.

Using a variety of data sources, including Medicaid and Medicare data, the researchers identified 65,618 patients 65 years or older residing in nursing homes in 45 States. All had started treatment with an antipsychotic after their admission between 2001 and 2005. Nearly half of the nursing homes studied (45 percent) never prescribed a conventional antipsychotic medication. In fact, 91.2 percent of patients started treatment with an atypical medication. Of the 8.8 percent of patients treated with a conventional medication, the most frequently prescribed drugs were haloperidol (86 percent) and chlorpromazine (8 percent).

Among atypical agents, the most popular choices were risperidone (41 percent) followed by olanzapine (32 percent) and quetiapine (23 percent). Nursing homes that favored conventional agents tended to have a larger proportion of less educated patients. They also had a greater proportion of patients with congestive heart failure and those with a history of hypnotic medication use. Facilities preferring atypical agents had more white patients and more patients with dementia or depression. Nursing homes prescribing conventional agents tended to be hospital-based, while those prescribing atypical agents tended to be larger, urban-based facilities with special Alzheimer care units and a team-based approach to care.

Individually, patient characteristics accounted for 36 percent of the between-nursing home variation in prescribing (atypical vs. conventional antipsychotic), facility characteristics for 23 percent, and nursing home prescribing tendency (prescribing 'culture') for 81 percent. The study was supported in part by the Agency for Healthcare Research and Quality (HS17918).

See "Variation in antipsychotic treatment choice across US nursing homes," by Krista F. Huybrechts, MS, PhD, Kenneth J. Rothman, DrPH, M. Alan Brookhart, PhD, and others in the February 2012 Journal of Clinical Psychopharmacology 32(1), pp. 11-17.

KB

Page last reviewed January 2013
Internet Citation: Antipsychotic choices in nursing homes partly influenced by nursing home’s prescribing culture: Elderly Health/Long-Term Care. January 2013. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/news/newsletters/research-activities/13jan/0113RA18.html

 

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care