Effects of Visitation Restriction on Antipsychotic Drug Use among Nursing Home Residents with ADRD during the COVID-19 Pandemic.

The pre-policy period was only the first 11 weeks of 2020, so the initial trend rests on few weekly observations and may be affected by winter seasonality. The study measured facility-level weekly prevalence, not individual residents, so it cannot show which residents started, stopped, or changed antipsychotics or why. Mortality outside the nursing home was not reliably recorded, and the resident and facility mix changed over time. Participating facilities decreased over time, which increased variance and reduced power; a sensitivity analysis on fully observed facilities did not materially change results. The authors did not focus on statistical significance, and many policy-effect confidence limits include zero, so the result is best read as no clear association rather than proof of no effect. Antipsychotics were analyzed as one class, and ADRD status depended on documented diagnoses.

The work was supported by NIH grant 2P01AG027296–11. Brown University receives monthly electronic health record data from a large multistate nursing home data-sharing cooperative, and CMS data use was covered by a Data Use Agreement with waiver of consent. No author conflicts are reported in the supplied text.

Do not conclude that family visitation restrictions caused the rise in antipsychotic use. The study found no clear immediate or long-term policy effect, and it cannot separate visitation restrictions from other pandemic factors such as staffing shortages and isolation.