@article{
 title = {Antipsychotic use in nursing homes varies by psychiatric consultant},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 keywords = {Aged,Antipsychotic Agents/administration & dosage,Consultants/statistics & numerical data,Cross-Sectional Studies,Drug Utilization/statistics & numerical data,Female,Homes for the Aged/statistics & numerical data,Humans,Inappropriate Prescribing/statistics & numerical d,Male,Middle Aged,Nursing Homes/statistics & numerical data,Physician's Practice Patterns/statistics & numeric,Prevalence,Psychiatry/statistics & numerical data,Quality of Health Care/statistics & numerical data},
 pages = {267-271},
 volume = {52},
 month = {3},
 city = {*University of Massachusetts Medical School daggerMeyers Primary Care Institute, Worcester, MA double daggerQualidigm, Wethersfield, CT section signMassachsuetts College of Pharmacy and Health Sciences, Worcester, MA.},
 id = {b19f54cb-fab3-3dea-811c-117436fba829},
 created = {2016-08-20T16:52:45.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
 hidden = {false},
 source_type = {JOUR},
 notes = {ID: 69243; GR: K01 AG031836/AG/NIA NIH HHS/United States; GR: K01AG031836/AG/NIA NIH HHS/United States; GR: R18 HS 019351/HS/AHRQ HHS/United States; JID: 0230027; 0 (Antipsychotic Agents); NIHMS544145; OID: NLM: NIHMS544145 [Available on 03/01/15]; OID: NLM: PMC3948216 [Available on 03/01/15]; PMCR: 2015/03/01 00:00; ppublish},
 folder_uuids = {966ab323-a0e8-4fc2-897a-595b3dcfd334},
 private_publication = {false},
 abstract = {BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys to October 2009-September 2010 Minimum Data Set, Nursing Home Compare, the US Census, and pharmacy dispensing data. MEASURES: The main exposure is the psychiatric consultant group and the main outcome is NH-level prevalence of atypical antipsychotic use. We calculated annual means and interquartile ranges of NH-level antipsychotic use for each consultant group and arrayed consultant groups from lowest to highest prevalence. Generalized linear models were used to predict antipsychotic prescribing adjusting for resident case-mix and facility characteristics. Observed versus predicted antipsychotic prescribing levels were compared for each consultant group. RESULTS: Seven psychiatric consultant groups served a range of 3-27 study facilities. Overall mean facility-level antipsychotic prescribing was 19.2%. Mean prevalence of antipsychotic prescribing ranged from 12.2% (SD, 5.8) in the lowest consultant group to 26.4% (SD, 3.6) in the highest group. All facilities served by the highest-ranked consultant group had observed antipsychotic levels exceeding the overall study mean with half exceeding predictions for on-label indications, whereas most facilities served by the lowest-ranked consultant group had observed levels below the overall study and predicted means. CONCLUSIONS: Preliminary evidence suggests that psychiatric consultant groups affect NH antipsychotic prescribing independent of resident case-mix and facility characteristics.},
 bibtype = {article},
 author = {Tjia, J and Field, T and Lemay, C and Mazor, K and Pandolfi, M and Spenard, A and Ho, S Y and Kanaan, A and Donovan, J and Gurwitz, J H and Briesacher, B},
 journal = {Medical care},
 number = {3}
}

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OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys to October 2009-September 2010 Minimum Data Set, Nursing Home Compare, the US Census, and pharmacy dispensing data. MEASURES: The main exposure is the psychiatric consultant group and the main outcome is NH-level prevalence of atypical antipsychotic use. We calculated annual means and interquartile ranges of NH-level antipsychotic use for each consultant group and arrayed consultant groups from lowest to highest prevalence. Generalized linear models were used to predict antipsychotic prescribing adjusting for resident case-mix and facility characteristics. Observed versus predicted antipsychotic prescribing levels were compared for each consultant group. RESULTS: Seven psychiatric consultant groups served a range of 3-27 study facilities. Overall mean facility-level antipsychotic prescribing was 19.2%. Mean prevalence of antipsychotic prescribing ranged from 12.2% (SD, 5.8) in the lowest consultant group to 26.4% (SD, 3.6) in the highest group. All facilities served by the highest-ranked consultant group had observed antipsychotic levels exceeding the overall study mean with half exceeding predictions for on-label indications, whereas most facilities served by the lowest-ranked consultant group had observed levels below the overall study and predicted means. CONCLUSIONS: Preliminary evidence suggests that psychiatric consultant groups affect NH antipsychotic prescribing independent of resident case-mix and facility characteristics.","bibtype":"article","author":"Tjia, J and Field, T and Lemay, C and Mazor, K and Pandolfi, M and Spenard, A and Ho, S Y and Kanaan, A and Donovan, J and Gurwitz, J H and Briesacher, B","journal":"Medical care","number":"3","bibtex":"@article{\n title = {Antipsychotic use in nursing homes varies by psychiatric consultant},\n type = {article},\n year = {2014},\n identifiers = {[object Object]},\n keywords = {Aged,Antipsychotic Agents/administration & dosage,Consultants/statistics & numerical data,Cross-Sectional Studies,Drug Utilization/statistics & numerical data,Female,Homes for the Aged/statistics & numerical data,Humans,Inappropriate Prescribing/statistics & numerical d,Male,Middle Aged,Nursing Homes/statistics & numerical data,Physician's Practice Patterns/statistics & numeric,Prevalence,Psychiatry/statistics & numerical data,Quality of Health Care/statistics & numerical data},\n pages = {267-271},\n volume = {52},\n month = {3},\n city = {*University of Massachusetts Medical School daggerMeyers Primary Care Institute, Worcester, MA double daggerQualidigm, Wethersfield, CT section signMassachsuetts College of Pharmacy and Health Sciences, Worcester, MA.},\n id = {b19f54cb-fab3-3dea-811c-117436fba829},\n created = {2016-08-20T16:52:45.000Z},\n file_attached = {false},\n profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},\n group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},\n last_modified = {2017-03-14T09:54:45.334Z},\n read = {false},\n starred = {false},\n authored = {false},\n confirmed = {true},\n hidden = {false},\n source_type = {JOUR},\n notes = {ID: 69243; GR: K01 AG031836/AG/NIA NIH HHS/United States; GR: K01AG031836/AG/NIA NIH HHS/United States; GR: R18 HS 019351/HS/AHRQ HHS/United States; JID: 0230027; 0 (Antipsychotic Agents); NIHMS544145; OID: NLM: NIHMS544145 [Available on 03/01/15]; OID: NLM: PMC3948216 [Available on 03/01/15]; PMCR: 2015/03/01 00:00; ppublish},\n folder_uuids = {966ab323-a0e8-4fc2-897a-595b3dcfd334},\n private_publication = {false},\n abstract = {BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys to October 2009-September 2010 Minimum Data Set, Nursing Home Compare, the US Census, and pharmacy dispensing data. MEASURES: The main exposure is the psychiatric consultant group and the main outcome is NH-level prevalence of atypical antipsychotic use. We calculated annual means and interquartile ranges of NH-level antipsychotic use for each consultant group and arrayed consultant groups from lowest to highest prevalence. Generalized linear models were used to predict antipsychotic prescribing adjusting for resident case-mix and facility characteristics. Observed versus predicted antipsychotic prescribing levels were compared for each consultant group. RESULTS: Seven psychiatric consultant groups served a range of 3-27 study facilities. Overall mean facility-level antipsychotic prescribing was 19.2%. Mean prevalence of antipsychotic prescribing ranged from 12.2% (SD, 5.8) in the lowest consultant group to 26.4% (SD, 3.6) in the highest group. All facilities served by the highest-ranked consultant group had observed antipsychotic levels exceeding the overall study mean with half exceeding predictions for on-label indications, whereas most facilities served by the lowest-ranked consultant group had observed levels below the overall study and predicted means. CONCLUSIONS: Preliminary evidence suggests that psychiatric consultant groups affect NH antipsychotic prescribing independent of resident case-mix and facility characteristics.},\n bibtype = {article},\n author = {Tjia, J and Field, T and Lemay, C and Mazor, K and Pandolfi, M and Spenard, A and Ho, S Y and Kanaan, A and Donovan, J and Gurwitz, J H and Briesacher, B},\n journal = {Medical care},\n number = {3}\n}","author_short":["Tjia, J.","Field, T.","Lemay, C.","Mazor, K.","Pandolfi, M.","Spenard, A.","Ho, S., Y.","Kanaan, A.","Donovan, J.","Gurwitz, J., H.","Briesacher, B."],"bibbaseid":"tjia-field-lemay-mazor-pandolfi-spenard-ho-kanaan-etal-antipsychoticuseinnursinghomesvariesbypsychiatricconsultant-2014","role":"author","urls":{},"keyword":["Aged","Antipsychotic Agents/administration & dosage","Consultants/statistics & numerical data","Cross-Sectional Studies","Drug Utilization/statistics & numerical data","Female","Homes for the Aged/statistics & numerical data","Humans","Inappropriate Prescribing/statistics & numerical d","Male","Middle Aged","Nursing Homes/statistics & numerical data","Physician's Practice Patterns/statistics & numeric","Prevalence","Psychiatry/statistics & numerical data","Quality of Health Care/statistics & numerical data"],"downloads":0},"search_terms":["antipsychotic","use","nursing","homes","varies","psychiatric","consultant","tjia","field","lemay","mazor","pandolfi","spenard","ho","kanaan","donovan","gurwitz","briesacher"],"keywords":["aged","antipsychotic agents/administration & dosage","consultants/statistics & numerical data","cross-sectional studies","drug utilization/statistics & numerical data","female","homes for the aged/statistics & numerical data","humans","inappropriate prescribing/statistics & numerical d","male","middle aged","nursing homes/statistics & numerical data","physician's practice patterns/statistics & numeric","prevalence","psychiatry/statistics & numerical data","quality of health care/statistics & numerical data"],"authorIDs":[]}