title: Effect of the Omnibus Reconciliation Act 1987 on antipsychotic prescribing in nursing home residents.
abstract: OBJECTIVE
  To determine the impact of OBRA 87 on antipsychotic prescribing in a 485-bed nursing home.
  
  
  METHODS
  Twelve-month retrospective cohort review of medical charts, medication administration records, and computerized pharmacy records.
  
  
  METHODS
  The percent of residents by diagnostic group and antipsychotic use.
  
  
  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 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.
  
  
  CONCLUSIONS
  OBRA 87 had a significant impact on antipsychotic use in this facility.
authors.affiliation: College of Pharmacy, University of Illinois at Chicago 60612.
authors.forename: T P
authors.initials: TP
authors.lastname: Semla
authors.forename: K
authors.initials: K
authors.lastname: Palla
authors.forename: B
authors.initials: B
authors.lastname: Poddig
authors.forename: D J
authors.initials: DJ
authors.lastname: Brauner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002641:Chicago; D015331:Cohort Studies; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D003953:Diagnosis-Related Groups; D004363:Drug Utilization / Q000639:trends; D035082:Federal Government; D005260:Female; D033161:Government Regulation; D017408:Guidelines as Topic; D006801:Humans; D007380:Intermediate Care Facilities / Q000331:legislation & jurisprudence / Q000592:standards*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018579:Patient Selection; D012189:Retrospective Studies; D014481:United States
chemical_list: D014150:Antipsychotic Agents