Impact of deprescribing AChEIs on aggressive behaviors and antipsychotic prescribing.
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ABSTRACT: Introduction
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.
SUBMITTER: Niznik JD
PROVIDER: S-EPMC7138718 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
Impact of deprescribing AChEIs on aggressive behaviors and antipsychotic prescribing.
Niznik Joshua D JD Zhao Xinhua X He Meiqi M Aspinall Sherrie L SL Hanlon Joseph T JT Nace David D Thorpe Joshua M JM Thorpe Carolyn T CT
Alzheimer's & dementia : the journal of the Alzheimer's Association 20200213 4
<h4>Introduction</h4>We evaluated the impact of deprescribing acetylcholinesterase inhibitors (AChEIs) on aggressive behaviors and incident antipsychotic use in nursing home (NH) residents with severe dementia.<h4>Methods</h4>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 prescrip ...[more]
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