Inappropriate Antipsychotic Use: The Impact of Nursing Home Socioeconomic and Racial Composition

OBJECTIVES Previous research suggests black nursing home (NH) residents are more likely to receive inappropriate antipsychotics. Our aim was to examine how NH characteristics, particularly the racial and socioeconomic composition of residents, are associated with the inappropriate use of antipsychot...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2020-03, Vol.68 (3), p.630-636
Main Authors: Fashaw, Shekinah, Chisholm, Latarsha, Mor, Vincent, Meyers, David J., Liu, Xinliang, Gammonley, Denise, Thomas, Kali
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antipsychotic Agents - adverse effects
Antipsychotics
Black or African American - statistics & numerical data
Female
Healthcare Disparities
Humans
Longitudinal Studies
Male
Medicaid
Medicaid - statistics & numerical data
medication restraint use
nursing home
Nursing Homes
Prevalence
Psychotropic drugs
Quality of care
Racial Groups
racial/ethnic disparities
socioeconomic disparities
Socioeconomic Factors
United States
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Summary:OBJECTIVES Previous research suggests black nursing home (NH) residents are more likely to receive inappropriate antipsychotics. Our aim was to examine how NH characteristics, particularly the racial and socioeconomic composition of residents, are associated with the inappropriate use of antipsychotics. DESIGN This study used a longitudinal approach to examine national data from Long‐Term Care: Facts on Care in the US (LTCFocUS.org) between 2000 and 2015. We used a multivariate linear regression model with year and state fixed effects to estimate the prevalence of inappropriate antipsychotic use at the NH level. SETTING Free‐standing NHs in the United States. PARTICIPANTS The sample consisted of 12 964 NHs. MEASUREMENTS The outcome variable was inappropriate antipsychotic use at the facility level. The primary indicator variables were whether a facility had high proportions of black residents and the percentage of residents with Medicaid as their primary payer. RESULTS NHs with high and low proportions of blacks had similar rates of antipsychotic use in the unadjusted analyses. NHs with high proportions of black residents had significantly lower rates of inappropriate antipsychotic use (β = −2; P 
ISSN:0002-8614
1532-5415
1532-5415
DOI:10.1111/jgs.16316