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Impact of deprescribing AChEIs on aggressive behaviors and antipsychotic prescribing
Author(s) -
Niznik Joshua D.,
Zhao Xinhua,
He Meiqi,
Aspinall Sherrie L.,
Hanlon Joseph T.,
Nace David,
Thorpe Joshua M.,
Thorpe Carolyn T.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12054
Subject(s) - deprescribing , antipsychotic , dementia , medicine , polypharmacy , medical prescription , odds ratio , galantamine , minimum data set , olanzapine , nursing homes , psychiatry , schizophrenia (object oriented programming) , donepezil , pharmacology , nursing , disease
We evaluated the impact of deprescribing acetylcholinesterase inhibitors (AChEIs) on aggressive behaviors and incident antipsychotic use in nursing home (NH) residents with severe dementia. Methods We conducted a retrospective study of Medicare claims, Part D, Minimum Data Set for NH residents aged 65+ with severe dementia receiving AChEIs in 2016. Aggressive behaviors were measured using the aggressive behavior scale (ABS; n = 30,788). Incident antipsychotic prescriptions were evaluated among antipsychotic non‐users (n = 25,188). Marginal structural models and inverse probability of treatment weights were used to evaluate associations of AChEI deprescribing and outcomes. Results The severity of aggressive behaviors was low at baseline (mean ABS = 0.5) and was not associated with deprescribing AChEIs (0.002 increase in ABS, P = .90). Incident antipsychotic prescribing occurred in 5.1% of residents and was less likely with AChEI deprescribing (adjusted odds ratio = 0.52 [0.40–0.68], P <.001]). Discussion Deprescribing AChEIs was not associated with a worsening of aggressive behaviors or incident antipsychotic prescriptions.