Published On: 07-19-2018

Introduction: Antipsychotic use in nursing homes varies widely across the United States; inadequate staffing, skill mix, and geropsychiatric training impede sustained improvement.

Aim: This study identified risk factors of antipsychotic use in long-stay residents lacking qualifying or potentially qualifying diagnoses.

Method: This secondary analysis used 2015 Minimum Data Set and cost report data from 458 Missouri nursing homes. The full sample (N = 29,679) was split into two subsamples: residents with (N = 15,114) and without (N = 14,565) a dementia diagnosis. Separate logistic regression models were run.

Results: Almost 15% of the dementia subsample and 8.4% of the nondementia subsample received an antipsychotic medication in the past week. Post-traumatic stress disorder, psychosis indicators, behavioral symptoms, anxiety medication with and without anxiety diagnosis, depression medication with and without depression diagnosis, and nurse staffing were among the strongest predictors of antipsychotic use in both subsamples. Simulation analyses showed decreased odds of receiving an antipsychotic in both subsamples when registered nurse hours matched the national average.

Discussion: Matching nurse staffing mix to the national average may improve antipsychotic use in nursing homes.

Implications: Knowledge of antipsychotic use risk factors use can inform care planning and staff education to minimize use of these medications in all but severe cases.

Phillips, L.J., Birtley, N.M., Petroski, G.F., Siem, C., & Rantz, M. (2018). An observational study of antipsychotic medication use among long-stay nursing home residents without qualifying diagnoses. Journal of Psychiatric and Mental Health Nursing, 25(5-6), 1-12.*

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