{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:58:29Z","timestamp":1785553109676,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG056407"],"award-info":[{"award-number":["R01AG056407"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03AG060073"],"award-info":[{"award-number":["R03AG060073"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Psychotropic and opioid medications are routinely prescribed for symptom management in hospice, but national estimates of prescribing are lacking. Changes in Medicare hospice payment in 2014 provide the first opportunity to examine psychotropic and opioid prescribing among hospice beneficiaries, and the factors associated with use of specific medication classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional analysis of a 20% sample of traditional and managed Medicare with Part D enrolled in hospice, 2014\u20132016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Beneficiaries enrolled in the Medicare hospice benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Medicare beneficiaries \u226565 newly enrolled in hospice between July 1, 2014 and December 31, 2016 (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0554,022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome<\/jats:title>\n                    <jats:p>Prevalence of psychotropic and opioid medication prescribing by class and factors associated with prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>70.3% of hospice beneficiaries were prescribed a psychotropic and 63.3% were prescribed an opioid. The most common psychotropic classes prescribed were: benzodiazepines (60.6%), antipsychotics (38.3%), antidepressants (18.4%), and antiepileptics (10.2%). Lorazepam (56.4%), morphine (52.8%), and haloperidol (28.6%) were received by the most beneficiaries. Prevalence of any psychotropic and opioid prescription was highest among beneficiaries who were female (76.7%), non\u2010Hispanic white (76.6%), and those with cancer (78.9%). Compared to white beneficiaries, non\u2010Hispanic black beneficiaries were less likely to receive nearly every class of medication, with significantly lower odds of receiving opioids (64.1% vs 57.9%; AOR 0.75, 95% CI 0.72\u20130.77) and benzodiazepines (61.6% vs 52.2%; AOR 0.66, 95% CI 0.64\u20130.68). Differences were seen across hospice diagnosis; those with cancer were more likely to receive opioids, benzodiazepines, and antipsychotics but less likely to receive antidepressants and antiepileptics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Psychotropic and opioid medications are frequently prescribed in hospice. Observed variations in prescribing across race and ethnicity may reflect disparities in prescribing as well as patient preferences for care. Further work is important to understand factors driving prescribing given limited studies surrounding medication prescribing in hospice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17085","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T09:59:28Z","timestamp":1615197568000},"page":"1479-1489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Prevalence of psychotropic and opioid prescribing among hospice beneficiaries in the United States, 2014\u20132016"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-0150","authenticated-orcid":false,"given":"Lauren B.","family":"Gerlach","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen C.","family":"Kales","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of California  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyungjin Myra","family":"Kim","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Center for Clinical Management Research VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Strominger","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Covinsky","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Teno","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oregon Health and Sciences University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P. W.","family":"Bynum","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4740-2640","authenticated-orcid":false,"given":"Donovan T.","family":"Maust","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Center for Clinical Management Research VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"National Hospice and Palliative Care Organization.NHPCO Facts and Figures 2017: Hospice Care in America. 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Medicare Learning Network Matters Number: MM8358. Outreach Education: Medicare Learning Network.2015.https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNMattersArticles\/Downloads\/mm8358.pdf. Accessed on June 15 2020."},{"key":"e_1_2_12_14_1","unstructured":"Center for Medicare Chronic Care Policy Group.Medicare Hospice Payment Reform: Analysis of How the Medicare Hospice Benefit is Used. 2015.https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/Hospice\/Downloads\/December-2015-Technical-Report.pdf. Accessed September 15 2019."},{"key":"e_1_2_12_15_1","unstructured":"Department of Health and Human Services Office of Inspector General.Medicare Part D is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit. 2019.https:\/\/oig.hhs.gov\/oas\/reports\/region6\/61708004.asp. Accessed August 1 2020."},{"key":"e_1_2_12_16_1","unstructured":"University of Washington. Rural Health Research Center. 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