Review
Geriatrics & Gerontology
Jessica P. Lipori, Emily Tu Ba, Theresa I. Shireman, Lauren Gerlach, Antoinette B. Coe, Kira L. Ryskina
Summary: This scoping review summarizes current evidence on the facility and prescriber characteristics associated with potentially harmful medication use in nursing homes, providing insights for the development of interventions to reduce this practice.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Molly Candon, Julie Strominger, Lauren B. Gerlach, Donovan T. Maust
Summary: This study found that the use of antiepileptic drugs among nursing home residents with Alzheimer's disease and related dementias is increasing, while the prescribing rates of antipsychotic and opioid drugs are declining. The study also revealed differences in prescribing rates based on the presence of disruptive behaviors or reported pain. The findings suggest that further investigation is needed regarding the risk-benefit ratio of antiepileptic drug prescribing for dementia care.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Daniel A. Harris, Laura C. Maclagan, Priscila Pequeno, Andrea Iaboni, Peter C. Austin, Laura C. Rosella, Jun Guan, Colleen J. Maxwell, Susan E. Bronskill
Summary: This study examined the changes in medication initiation following antipsychotic reduction efforts in nursing homes. It found a significant decrease in antipsychotic initiation over time, while trazodone initiation showed a modest increase. The increase in trazodone initiation was larger among residents with dementia.
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
(2023)
Review
Oncology
Patricia Bramati, Eduardo Bruera
Summary: Delirium is a common generalized cerebral dysfunction near the end of life, especially in cancer patients. It is distressing for patients, families, and caregivers, with management goals being controversial. Effective recognition of delirium is important, although reversibility is often not achievable. Non-pharmacological and pharmacological interventions are commonly used but largely unproven, with palliative sedation being considered for refractory cases. Psychological assistance should be available to patients and families at all times.
Article
Neurosciences
Ana Aliana Miron, Paula Simina Petric, Andreea Teodorescu, Petru Ifteni, Gabriela Chele, Andreea Silvana Szalontay
Summary: Schizophrenia is a chronic disease characterized by relapses and remission periods. The main treatment option is antipsychotics, but mood stabilizers and/or benzodiazepines are frequently prescribed as adjunctive therapy. This study found that stabilized schizophrenia patients continue to use benzodiazepines and mood stabilizers, regardless of the antipsychotic formulation. Patients receiving second-generation long-acting injectable antipsychotics are more likely to be stabilized on monotherapy. Further research is needed to clarify the benefits of current drug polypharmacy trends.
Article
Geriatrics & Gerontology
Esther S. Oh, Paul B. Rosenberg, Gail B. Rattinger, Elizabeth A. Stuart, Constantine G. Lyketsos, Jeannie-Marie S. Leoutsakos
Summary: This study found that the use of atypical antipsychotics in AD patients was associated with worse cognition and function, while the use of non-SSRI antidepressants was associated with better function. However, no drug class was associated with improvement in neuropsychiatric symptoms.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Psychiatry
Jonne Lintunen, Heidi Taipale, Antti Tanskanen, Ellenor Mittendorfer-Rutz, Jari Tiihonen, Markku Lahteenvuo
Summary: In the treatment of SCHAFF, clozapine, long-acting injectable antipsychotics, and combination therapy with mood stabilizers were associated with the best outcomes, while the use of quetiapine and benzodiazepines were associated with the worst outcomes.
SCHIZOPHRENIA BULLETIN
(2021)
Review
Pharmacology & Pharmacy
Asma AlDawsari, Trevor J. Bushell, Nouf Abutheraa, Shuzo Sakata, Sarah Al Hussain, Amanj Kurdi
Summary: This study aimed to examine the association between sedative-hypnotic medications and risk of dementia using a meta-analysis approach. The results showed that all investigated sedative-hypnotics did not have an increased risk of dementia except for benzodiazepines (BZDs). However, the observed association with BZDs did not persist after potential reverse causation and confounding by indication were excluded.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Emergency Medicine
Kellyn Engstrom, Alicia E. Mattson, Kristin Mara, Lucas Oliveira J. E. Silva, Fernanda Bellolio, Molly Moore Jeffery, Jessica Stanich, Caitlin S. Brown
Summary: This study compared the safety and effectiveness of benzodiazepines and antipsychotics for the management of acute agitation in older adults in the emergency department. The study found that there was no difference in the incidence of adverse events between the two groups, but the intubation rate was higher in the benzodiazepine group. The antipsychotic group had a higher treatment failure rate, driven by the need for 1:1 observation. Therefore, the selection of pharmacological treatment for agitation in older adults should consider individual factors to reduce the risk of adverse effects or treatment failure.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Review
Clinical Neurology
Alexander Brunnauer, Florian Herpich, Peter Zwanzger, Gerd Laux
Summary: The research indicates that long-term treatment with psychopharmacological medication can improve or stabilize driving performance of patients, but some patients may experience severe impairment under specific pharmacological treatments, highlighting the importance of cautious driving in these cases.
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY
(2021)
Article
Geriatrics & Gerontology
Rebecca H. Correia, Darly Dash, Jeffrey W. Poss, Andrea Moser, Paul R. Katz, Andrew P. Costa
Summary: This study characterizes the practice profile of nursing home physicians in Ontario, Canada, using two approaches: the NH specialist model. The results demonstrate the medical practice characteristics, locations, and billing patterns of physicians within Ontario NHs. Future research can explore the association between physician commitment and the quality of care provided to nursing home residents, which may lead to the development of quality metrics based on physician practice patterns.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Review
Geriatrics & Gerontology
Lisa L. Groom, Margaret M. McCarthy, Amy Witkoski Stimpfel, Abraham A. Brody
Summary: The use of telemedicine and telehealth in nursing homes has shown positive impacts on reducing emergency and hospital admissions, saving costs, and improving patient vital signs. Clinicians, residents, and families have generally positive perspectives on these technologies. However, the heterogeneity of research methods and small sample sizes may limit the generalizability of the study results.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Wenche H. Skretteberg, Ingunn Holmefoss, Maria Krogseth
Summary: The study assessed the frequency of delirium during acute events in nursing home patients, with 60% of patients developing delirium associated with the event, most commonly precipitated by infections. Regular use of benzodiazepines and a diagnosis of vascular dementia were identified as independent predisposing factors for delirium.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Substance Abuse
Eleni Domzaridou, Matthew J. Carr, Tim Millar, Roger T. Webb, Darren M. Ashcroft
Summary: A cohort study in England found that concurrent use of benzodiazepines, antipsychotics, gabapentinoids, antidepressants, Z-drugs or opioids increases the risk of non-fatal overdose among recipients of opioid agonist treatment.
Article
Nursing
Beate Andre, Frode F. Jacobsen, Gorill Haugan
Summary: This study explores leadership in Norwegian nursing homes, comparing those with and without the implementation of the JoLNH strategy. The findings suggest that the implementation of JoLNH may lead to increased motivation among staff and better control of changes and implementation processes, as well as a more trustful relationship between employees and leaders.
Article
Health Care Sciences & Services
Brian E. McGarry, David C. Grabowski
MEDICAL CARE RESEARCH AND REVIEW
(2020)
Article
Health Care Sciences & Services
Lacey Loomer, Ashvin Gandhi, Fangli Geng, David C. Grabowski
Summary: This study used a new data source, Caregiverlist, to collect private-pay prices for 12,000 nursing homes nationwide and found factors that affect prices.
MEDICAL CARE RESEARCH AND REVIEW
(2021)
Letter
Surgery
Andrew D. Wilcock, Michael L. Barnett, J. Michael McWilliams, David C. Grabowski, Ateev Mehrotra
Editorial Material
Medicine, General & Internal
David C. Grabowski, Vincent Mor
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Editorial Material
Medicine, General & Internal
David C. Grabowski, Karen E. Joynt Maddox
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Article
Geriatrics & Gerontology
Anne Tumlinson, William Altman, Jon Glaudemans, Howard Gleckman, David C. Grabowski
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2020)
Letter
Geriatrics & Gerontology
Scott A. Goldberg, Charles T. Pu, Ryan W. Thompson, Eden Mark, Thomas D. Sequist, David C. Grabowski
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2020)
Letter
Medicine, General & Internal
Michael L. Barnett, Lissy Hu, Thomas Martin, David C. Grabowski
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Article
Geriatrics & Gerontology
Hannah R. Abrams, Lacey Loomer, Ashvin Gandhi, David C. Grabowski
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2020)
Article
Geriatrics & Gerontology
Joseph G. Ouslander, David C. Grabowski
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2020)
Letter
Medicine, General & Internal
Brian E. McGarry, Gillian K. SteelFisher, David C. Grabowski, Michael L. Barnett
JAMA INTERNAL MEDICINE
(2021)
Article
Geriatrics & Gerontology
David C. Grabowski
Summary: Nursing homes in the United States often lack adequate nursing staff and a homelike environment, which was further exacerbated during the pandemic. The main reasons for these issues are the low reimbursement from state Medicaid payment systems and the lack of government accountability for how nursing homes spend their funding. To address these problems, reforms are needed in the payment system and oversight of nursing home expenditures.
INNOVATION IN AGING
(2022)
Article
Geriatrics & Gerontology
Brian E. McGarry, David C. Grabowski
Summary: Although some states have concerns about the woodwork effect, our study shows that expanding Medicaid HCBS does not lead to increased enrollment. Instead, it is associated with reduced nursing home population and institutional Medicaid LTSS spending. Each dollar directed to HCBS leads to $0.26 savings from decreased nursing home use, allowing states to serve more LTSS recipients at a lower cost.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Medicine, General & Internal
Michael L. Barnett, Karen E. Joynt Maddox, E. John Orav, David C. Grabowski, Arnold M. Epstein
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2020)
Article
Gerontology
Hari Sharma, Marcelo Coca Perraillon, Rachel M. Werner, David C. Grabowski, R. Tamara Konetzka
JOURNAL OF APPLIED GERONTOLOGY
(2020)