{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T04:17:57Z","timestamp":1768277877622,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T00:00:00Z","timestamp":1516579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["1131"],"award-info":[{"award-number":["1131"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To describe the settings of care in which antipsychotics that nursing home (NH) residents received were likely to have been initiated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Iowa NHs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Fee\u2010for\u2010service Medicare beneficiaries who had NH stays between January 1, 2011, and December 31, 2014, and had new use of antipsychotics during their NH stays, defined as no antipsychotic use in NHs in the last 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>A linked dataset of Chronic Condition Data Warehouse Medicare claims and Long\u2010Term Care Minimum Data Set (MDS) 3.0 was used to determine care settings of antipsychotic initiations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 7,496 residents with new antipsychotic use in NHs, 4,794 (64.0%, 95% confidence interval (CI)\u2009=\u200962.9\u201365.0%) initiated them in NHs, 1,392 (18.6%, 95% CI 17.7\u201319.5%) appeared to have had them initiated in hospitals, and 1,310 (17.5%, 95% CI\u2009=\u200916.6\u201318.3%) had antipsychotics first dispensed as outpatients. Antipsychotics were commonly prescribed during the early NH stays, and 3,026 (40.4%, 95% CI\u2009=\u200939.3\u201341.5%) of the entire sample received antipsychotic therapy within the first 7 days after NH admissions. Fifty\u2010eight percent (n\u2009=\u20094,348) of the study residents initiating antipsychotics had potentially appropriate antipsychotic indications according toMDS records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Most residents initiated antipsychotic therapy in NHs, confirming that NH providers are appropriate primary target of interventions to reduce antipsychotic initiation in their residents. However, many antipsychotics were continued from other settings, indicating a need to evaluate the necessity of continued antipsychotic treatment after such transitions of care. J Am Geriatr Soc 66:1082\u20131088: 2018.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15223","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T11:51:40Z","timestamp":1516621900000},"page":"1082-1088","source":"Crossref","is-referenced-by-count":17,"title":["Where Are Antipsychotics Prescribed in Nursing Homes Initiated?"],"prefix":"10.1111","volume":"66","author":[{"given":"Yan","family":"Zhang","sequence":"first","affiliation":[{"name":"From the Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena M.","family":"Letuchy","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan M.","family":"Carnahan","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology, College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2008.10.002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S1698"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e3181d6c0c6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301492"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-200012000-00018"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.211266"},{"key":"e_1_2_6_8_1","unstructured":"Centers for Medicare & Medicaid Services2015. Nursing Home Data Compendium [on\u2010line]. Available athttps:\/\/www.cms.gov\/medicare\/provider-enrollment-and-certification\/certificationandcomplianc\/nhs.htmlAccessed August 31 2016."},{"key":"e_1_2_6_9_1","unstructured":"U.S. Food and Drug Administration2005. Public Health Advisory: Deaths with Antipsychotics in Elderly Patients with Behavioral Disturbances [on\u2010line]. Available athttps:\/\/www.fda.gov\/drugs\/drugsafety\/postmarketdrugsafetyinformationforpatientsandproviders\/ucm053171Accessed December 28 2015."},{"key":"e_1_2_6_10_1","unstructured":"U.S. Food and Drug Administration2008. Information for Healthcare Professionals: Conventional Antipsychotics [on\u2010line]. Available athttps:\/\/www.fda.gov\/Drugs\/DrugSafety\/PostmarketDrugSafetyInformationforPatientsandProviders\/ucm124830.htmAccessed December 28 2015."},{"key":"e_1_2_6_11_1","unstructured":"ShekelleP MaglioneM BagleySet al. Efficacy and Comparative Effectiveness of Off\u2010Label Use of Atypical Antipsychotics. Agency for Healthcare Research and Quality (US) 2007[on\u2010line]. Available athttps:\/\/effectivehealthcare.ahrq.gov\/sites\/default\/files\/pdf\/atypical-antipsychotics-off-label_research.pdfAccessed December 28 2015."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e977"},{"key":"e_1_2_6_13_1","unstructured":"Centers for Medicare & Medicaid Services2012. CMS Announces Partnership to Improve Dementia Care in Nursing Homes [on\u2010line]. Available athttps:\/\/www.cms.gov\/Newsroom\/MediaReleaseDatabase\/Press-releases\/2012-Press-releases-items\/2012-05-30.htmlAccessed December 31 2015."},{"key":"e_1_2_6_14_1","unstructured":"Centers for Medicare & Medicaid Services2014. National Partnership to Improve Dementia Care Exceeds Goal to Reduce Use of Antipsychotic Medications in Nursing Homes: CMS Announces New Goal [on\u2010line]. Available athttps:\/\/www.cms.gov\/Newsroom\/MediaReleaseDatabase\/Press-releases\/2014-Press-releases-items\/2014-09-19.htmlAccessed December 31 2015."},{"key":"e_1_2_6_15_1","unstructured":"TritzK LaughmanM O'DonnellD.Update Report on the Centers for Medicare & Medicaid Services (CMS) National Partnership to Improve Dementia Care in Nursing Homes: 2014 Quarter 2\u20132015 Quarter 3 [online]. Available athttps:\/\/www.cms.gov\/Medicare\/Provider-Enrollment-and-Certification\/SurveyCertificationGenInfo\/Downloads\/Survey-and-Cert-Letter-16-28.pdfAccessed August 29 2016."},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200012000-00003"},{"key":"e_1_2_6_17_1","unstructured":"LongstrethGF.Approach to the adult with nausea and vomiting. In: UpToDate Post TW (Ed) UpToDate Waltham MA.www.uptodate.com. 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