{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T03:21:44Z","timestamp":1772767304183,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG066864"],"award-info":[{"award-number":["K23AG066864"]}],"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":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Benzodiazepine and antipsychotic medications are routinely prescribed for symptom management in hospice patients, but have significant risks for older adults. We explored the extent to which patient and hospice agency characteristics are associated with variations in their prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional analysis of hospice\u2010enrolled Medicare beneficiaries aged \u226565\u2009years in 2017 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091,393,622 in 4219 hospice agencies). The main outcome was the hospice agency\u2010level rate of enrollees with benzodiazepine and antipsychotic prescription fills divided into quintiles. Rate ratios were used to compare the agencies with the highest and lowest prescription across patient and agency characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2017, hospice agency prescribing rates varied widely: for benzodiazepines, from a median of 11.9% (IQR 5.9,22.2) in the lowest\u2010prescribing quintile to 80.0% (IQR 76.9,84.2) in the highest\u2010prescribing quintile; for antipsychotics, it ranged from 5.5% (IQR 2.9,7.7) in the lowest to 63.9% (IQR 56.1,72.0) in the highest. Among the highest benzodiazepine\u2010 and antipsychotic\u2010 prescribing hospice agencies, there was a smaller proportion of patients from minoritized populations (benzodiazepine: non\u2010Hispanic Black rate ratio [RR] [Q5\/Q1] 0.7, 95% CI 0.6\u20130.7, Hispanic RR 0.4, 95% CI 0.3\u20130.5; antipsychotic: non\u2010Hispanic Black RR 0.7, 95% CI 0.6\u20130.8, Hispanic RR 0.4, 95% CI 0.3\u20130.5). A greater proportion of rural beneficiaries were in the highest benzodiazepine\u2010prescribing quintile (RR 1.3, 95% CI 1.2\u20131.4), whereas this relationship was not present for antipsychotics. Larger hospice agencies were over\u2010represented in the highest prescribing quintile for both benzodiazepines (RR 2.6, 95% CI 2.5\u20132.7) and antipsychotics (RR 2.7, 95% CI 2.6\u20132.8), as were for\u2010profit agencies (benzodiazepine: RR 2.4, 95% CI 2.3\u20132.4; antipsychotic: RR 2.3, 95% CI 2.2\u20132.4). Prescribing rates varied widely across Census regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prescribing in hospice settings varies markedly across factors other than the clinical characteristics of enrolled patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18344","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T05:11:55Z","timestamp":1679893915000},"page":"2571-2578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hospice agency characteristics associated with benzodiazepine and antipsychotic prescribing"],"prefix":"10.1111","volume":"71","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":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Strominger","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Teno","sequence":"additional","affiliation":[{"name":"Health Services, Policy, and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.03.014"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17085"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.05.016"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909113476132"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.3.5.485"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7491"},{"key":"e_1_2_11_8_1","unstructured":"Centers for Medicare and Medicaid Services.Medicare Learning Network Matters Number: MM8358. 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