ASSOCIATIONS BETWEEN RESIDENT, FACILITY AND COMMUNITY CHARACTERISTICS AND USE OF ANTIPSYCHOTIC MEDICATIONS IN RHODE ISLAND NURSING HOMES
D.A. Harris, R. Youssef, K.D. Pelland, N. Silva-Odom, A.J. DaCunha, L. McNicoll
Jour Nursing Home Res 2017;3:110-115
Background: Antipsychotic medications (APMs) have been used to treat mood and behavior dysregulation associated with dementia. However, APMs are associated with several adverse health outcomes. Federal initiatives have successfully reduced the use of APMs in nursing homes nationally; however, from 2014 to 2017, the use of APMs in Rhode Island (RI) has increased. Objective: Delineate resident, facility and community characteristics associated with APM use in RI. Design: Cross-sectional. Setting: RI, USA. Participants: RI nursing homes (N=84). Measurements: Data for RI nursing homes were obtained from the Certification and Survey Provider Enhanced Reporting (CASPER) system. The main dependent variable was a facility’s APM use. Resident, facility and community characteristics were included in the analysis. Logit-binomial regression identified which independent variables were associated with APM prevalence. Results: APM use was at an average of 18.8% (SD: 13.0%) for residents in RI’s nursing homes. After adjustment for confounding variables, the use of antianxiety and antidepressant medications, psychiatric diagnoses, and behavioral symptoms were positively associated with APM use. Dementia and behavioral care plans were associated with lower APM use (β = -1.38 [95%CI= -2.21, -0.55]; β = -0.59 [95%CI= -0.86, -0.32], respectively). Compared to non-profit facilities, for-profit facilities had greater use of APMs (β = 0.81 [95%CI= 0.39, 1.24]). Compared to nursing homes in low-income communities, homes in middle- and high-income communities were associated with less use of APMs (β = -0.67 [95%CI= -1.30, -0.25]; β = -0.75 [95%CI= -1.30, -0.20], respectively). Conclusions: Findings assist quality improvement by identifying which nursing home characteristics are associated with APM use.
D.A. Harris ; R. Youssef ; K.D. Pelland ; N. Silva-Odom ; A.J. DaCunha ; L. McNicoll (2017): Associations between Resident, Facility and Community Characteristics and Use of Antipsychotic Medications in Rhode Island Nursing Homes. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2017.17