Nursing Home Characteristics Associated with High and Low Levels of Antipsychotic, Benzodiazepine, and Opioid Prescribing to Residents with Alzheimer's Disease and Related Dementias: A Cross-Sectional Analysis.

The analysis is cross-sectional, so it can estimate associations but cannot show that nursing-home characteristics caused prescribing differences. Prescription fills were used as a proxy for medication use, so the study could not determine why medications were prescribed or whether they were appropriate. The sample included only older adults with Alzheimer's disease or related dementias in fee-for-service Medicare with Part D coverage and in nursing homes with at least 10 residents with Alzheimer's disease or related dementias, so it may not apply to Medicare Advantage residents or smaller nursing homes. Models were estimated at the nursing-home level, which may create aggregation bias; resident-level studies are needed to understand individual prescribing. The study did not test whether the associations are dynamic over time or whether the effect sizes are clinically meaningful. Interaction effects between nursing-home characteristics, such as nursing care and Medicaid payer mix, were not explored.

The supplied text does not report author financial conflicts. LTCFocus data are sponsored by the National Institute on Aging through a cooperative agreement with Brown University School of Public Health.

Do not conclude that facility characteristics such as registered nurse staffing cause lower prescribing. The study is cross-sectional, uses prescription fills as proxies for medication use, and cannot show whether medications were appropriate.