Most Antipsychotics Prescribed in Nursing Homes Initiated There

Researchers found that 64% of prescriptions were initiated in nursing homes, 18.6% in hospitals, and 17.5% in outpatient settings.
Researchers found that 64% of prescriptions were initiated in nursing homes, 18.6% in hospitals, and 17.5% in outpatient settings.

HealthDay News — Antipsychotic therapy prescribed to nursing home residents is mostly initiated in nursing homes rather than hospitals or outpatient settings, according to a study published in the June issue of the Journal of the American Geriatrics Society.

Yan Zhang, from the University of Iowa in Iowa City, and colleagues used a linked dataset of Chronic Condition Data Warehouse Medicare claims and Long-Term Care Minimum Data Set (MDS) 3.0 to determine care settings of antipsychotic initiations among 7496 fee-for-service Medicare beneficiaries who had nursing home stays between January 1, 2011, and December 31, 2014. 

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The researchers found that 64% of study participants had new antipsychotic use initiated in nursing homes, 18.6% had initiation in hospitals, and 17.5% had initiation in outpatient settings. Antipsychotics were often prescribed early in nursing home stays, with 40.4% of the entire sample receiving antipsychotic therapy within the first 7 days of nursing home admission. Just over half of antipsychotic initiations (58%) were potentially appropriate based on indications captured in MDS records. 

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"Most residents initiated antipsychotic therapy in nursing homes, confirming that nursing home providers are [an] appropriate primary target of interventions to reduce antipsychotic initiation in their residents," the authors write. "Many antipsychotics were continued from other settings, indicating a need to evaluate the necessity of continued antipsychotic treatment after such transitions of care."

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