+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents



Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents



Psychiatric Services 65(6): 781-788



The study compared the risk of all-cause hospitalization associated with use of first- versus second-generation antipsychotics among elderly nursing home residents who were eligible for both Medicare and Medicaid. A retrospective cohort study design was used to compare the risk of all-cause hospitalization among dual-eligible nursing home residents (≥65 years) during the 180 days after a new prescription for a first-generation (N=3,611) or a second-generation (N=46,293) antipsychotic. Propensity scores created from Medicare and Medicaid Analytic eXtract data were used to identify a matched cohort of equal numbers of users of each antipsychotic class (N=3,609). The Cox proportional model and the extended Cox hazard model were used to evaluate the risk of all-cause hospitalization in the matched cohort. The unadjusted rates of all-cause hospitalization were 21.3% and 30.5% among users of first- and second-generation antipsychotics, respectively. The Cox proportional model revealed a significant difference between the two classes in risk of all-cause hospitalization (hazard ratio [HR]=1.33, p<.001). There was no difference in hospitalization risk among users of first- versus second-generation antipsychotics within the first 20 days of use; however, the odds of hospitalization among users of first-generation antipsychotics increased by 58% after 20 days of use (HR=1.58, p<.001). The study findings suggest that use of first- versus second-generation antipsychotics lasting more than 20 days is associated with a differential risk of all-cause hospitalization, possibly due to differential safety profiles of the two classes. Consequently, there is a need to monitor the use of antipsychotics by elderly patients, especially after a period of initial use.

(PDF emailed within 0-6 h: $19.90)

Accession: 055586205

Download citation: RISBibTeXText

PMID: 24535474

DOI: 10.1176/appi.ps.201300093


Related references

Risk of pneumonia in elderly nursing home residents using typical versus atypical antipsychotics. Annals of PharmacoTherapy 47(4): 464-474, 2014

High-risk medication use by nursing home residents before and after hospitalization. Medical Care 52(10): 884-890, 2014

Nursing home residents at risk of hospitalization and the characteristics of their hospital stays. Gerontologist 35(1): 35-43, 1995

Hospitalization of nursing home residents in an acute-care geriatric department: direct versus emergency room admission. Israel Medical Association Journal 3(10): 734-738, 2001

Potentially inappropriate drug prescriptions and risk of hospitalization among older, Italian, nursing home residents: the ULISSE project. Drugs & Aging 27(9): 747-758, 2010

Relationship between state medicaid policies, nursing home racial composition, and the risk of hospitalization for black and white residents. Health Services Research 43(3): 869-881, 2008

Case-control study of exposure to medication and the risk of injurious falls requiring hospitalization among nursing home residents. American Journal of Epidemiology 145(8): 738-745, 1997

Seasonal variations in acute hospitalization and mortality among nursing home residents Results from LOVE Long-term care of Old people Via KorEan Nursing Home Network study. European Geriatric Medicine 4(3): 172-175, 2013

Fall and Fracture Risk in Nursing Home Residents With Moderate-to-Severe Behavioral Symptoms of Alzheimer's Disease and Related Dementias Initiating Antidepressants or Antipsychotics. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 72(5): 695-702, 2016

Anticholinergic Medication Burden and 5-Year Risk of Hospitalization and Death in Nursing Home Elderly Residents With Coronary Artery Disease. Journal of the American Medical Directors Association 17(11): 1056-1059, 2016

Antipsychotics are overprescribed for nursing home residents. Harvard Mental Health Letter 28(2): 7-7, 2011

A trial of a comprehensive nursing rehabilitation program for nursing home residents post-hospitalization. Research in Gerontological Nursing 2(1): 12-19, 2010

Comparative Effectiveness of Second-Generation Antidepressants in Reducing the Risk of Dementia in Elderly Nursing Home Residents with Depression. PharmacoTherapy 36(1): 38-48, 2016

The relationship of nursing staff to the hospitalization of nursing home residents. Research in Nursing & Health 31(3): 238-251, 2008

Hospitalization of nursing home residents. Jgim 11(Suppl 1): 143, 1996