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Consequences of Reduced Antipsychotic Prescribing in Nursing Homes

疗养院减少抗精神病药物处方的后果

基本信息

批准号：
8997047
负责人：
BECKY A BRIESACHER
金额：
$ 19.31万
依托单位：
NORTHEASTERN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-02-01 至 2018-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8997047
关键词：
Adult Adverse effects Affordable Care Act Anticonvulsants Antidepressive Agents Antipsychotic Agents Area Behavior Behavioral Symptoms Benefits and Risks Benzodiazepines Cardiovascular system Caring Case Mixes Cessation of life Clinical Country Data Data Set Dementia Early Diagnosis Elderly Enrollment Evaluation Frail Elderly Future Goals Health Health Benefit Home Nursing Care Hospitalization Incidence Intervention Label Lead Link Measures Medicare Medicare Part A Memantine Monitor Natural experiment Nebraska Nevada Nursing Homes Oklahoma Outcome Outcome Study Pattern Pharmaceutical Preparations Positioning Attribute Prevalence Psychotropic Drugs Randomized Controlled Trials Regimen Reporting Research Design Research Project Grants Risk Safety Series Tennessee Testing Therapeutic Therapeutic Uses Time Training Translating United States Centers for Medicare and Medicaid Services Update Vulnerable Populations Wyoming cerebrovascular dementia care evidence base experience improved mortality novel older patient programs response social media trend

项目摘要

DESCRIPTION (provided by applicant): One in 5 of the 1.4 million US nursing home residents receive antipsychotic drugs to manage dementia despite extensive evidence of marginal benefits and serious adverse effects including death. The Centers for Medicare and Medicaid Services recently launched a national campaign to reduce unnecessary prescribing of antipsychotics in the elderly but concerns have been raised that the initiative did more harm than good. The objectives of this study are to describe the current landscape of antipsychotic use in the nursing home setting and estimate how the antipsychotic reduction campaign influenced prescribing. A unique aspect of this study is to examine the extent of therapeutic substitution with medications that are not effective at managing dementia. We will also examine changes in important health outcomes such as behavioral symptoms and hospitalization. To complete these objectives, this research project will analyze an existing dataset of nursing home resident care plans linked to Medicare program data including Part D drug claims. This project should be in a unique position to inform the Medicare program and policymakers about the experience of nursing home residents related to antipsychotics and how to improve dementia care in nursing homes.

描述(由申请人提供)：在140万美国疗养院居民中，每5人中就有1人接受抗精神病药物治疗痴呆症，尽管有广泛的证据表明，这些药物具有边际益处和包括死亡在内的严重不良反应。医疗保险和医疗补助服务中心最近发起了一项全国性的运动，以减少老年人不必要的抗精神病药物处方，但有人担心这一倡议弊大于利。这项研究的目的是描述疗养院抗精神病药物使用的现状，并评估抗精神病药物减少运动如何影响处方。这项研究的一个独特方面是检查治疗替代治疗的程度，这些药物在管理痴呆症方面无效。我们还将检查重要健康结果的变化，如行为症状和住院时间。为了完成这些目标，本研究项目将分析现有的疗养院居民护理计划数据集，这些计划与包括D部分药物索赔在内的医疗保险计划数据相关联。这个项目应该处于一个独特的地位，向医疗保险计划和政策制定者通报疗养院居民与抗精神病药物有关的经验，以及如何改善疗养院的痴呆症护理。