Psychoactive Drug Prescribing Linked to Nursing Facility Hip Fractures

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Psychoactive drug prescription and minimum staffing requirements are modifiable factors
Psychoactive drug prescription and minimum staffing requirements are modifiable factors

HealthDay News — Much variation in the incidence of hip fractures in U.S. nursing home facilities remains unexplained, even after examining characteristics at the state and facility levels, according to a study published online January 16 in the Journal of the American Geriatrics Society.

Andrew R. Zullo, PharmD, PhD, from Brown University in Providence, RI, and colleagues used linked data from national Minimum Data Set assessments; Online Survey, Certification, and Reporting records; and Medicare claims to quantify the variation in hip fracture incidence across U.S. nursing home facilities and to examine facility- and state-level characteristics associated with hip fracture incidence. 

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The researchers found that the mean adjusted incidence rate of hip fractures for all facilities was 3.13 per 100 person-years. The highest rates of hip fracture were seen at facilities with greater percentages of residents taking psychoactive medications, those with fewer nursing hours per day per resident, and those with fewer direct care hours per day per resident. In combination, state and facility characteristics explained 6.7% of the variation in hip fracture, and resident characteristics accounted for 7.6% of the variation.

"Much of the variation in hip fracture incidence remained unexplained, although these findings indicate that potentially modifiable state and facility characteristics such as psychoactive drug prescribing and minimum staffing requirements could be addressed to help reduce the rate of hip fracture in U.S. nursing homes," the authors write.

One author disclosed financial ties to the nursing home industry.

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