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Effect of the Omnibus Reconciliation Act 1987 on Antipsychotic Prescribing in Nursing Home Residents
Author(s) -
Semla Todd P.,
Palla Kavita,
Poddig Barbara,
Brauner Daniel J.
Publication year - 1994
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1994.tb06865.x
Subject(s) - medicine , antipsychotic , nursing homes , dementia , retrospective cohort study , pharmacy , psychiatry , medical record , thioridazine , cohort , family medicine , antipsychotic agent , emergency medicine , nursing , schizophrenia (object oriented programming) , chlorpromazine , disease
Objective : To determine the impact of OBRA 87 on antipsychotic prescribing in a 485‐bed nursing home. Design : Twelve‐month retrospective cohort review of medical charts, medication administration records, and computerized pharmacy records. Measurements : The percent of residents by diagnostic group and antipsychotic use. Main Results : An attempt was made to stop or lower the dose of antipsychotic in 75% of the 107 residents studied. Antipsychotics were stopped in 45% of residents with a dementia‐only diagnosis and 25% of residents with a psychiatric diagnosis ( P < 0.05). Residents with documented symptoms appropriate for the use of an antipsychotic, per OBRA 87, were significantly less likely to have their antipsychotic stopped. Twenty percent of residents whose antipsychotic was either stopped or its dose lowered had the agent restarted or its dose increased. Conclusion : OBRA 87 had a significant impact on antipsychotic use in this facility.