title: Rationales that providers and family members cited for the use of antipsychotic medications in nursing home residents with dementia.
abstract: OBJECTIVE
  To describe the rationales that providers and family members cite for the use of antipsychotic medications in people with dementia living in nursing homes (NHs).
  
  
  METHODS
  Qualitative, descriptive study.
  
  
  METHODS
  Twenty-six medium-sized and large facilities in five Centers for Medicare and Medicaid Services regions.
  
  
  METHODS
  Individuals diagnosed with dementia who received an antipsychotic medication.
  
  
  METHODS
  Data were collected from medical record abstraction and interviews with prescribers, administrators, direct care providers, and family members. Textual data from medical record abstraction and responses to open-ended interview questions were analyzed using directed content analysis techniques. A coding scheme was developed, and coded reasons for antipsychotic prescribing were summarized across all sources.
  
  
  RESULTS
  Major categories of reasons for use of antipsychotic medications in the 204 NH residents in the study sample were behavioral (n = 171), psychiatric (n = 159), emotional states (n = 105), and cognitive diagnoses or symptoms (n = 114). The most common behavioral reasons identified were verbal (n = 91) and physical (n = 85) aggression. For the psychiatric category, psychosis (n = 95) was most frequently described. Anger (n = 93) and sadness (n = 20) were the most common emotional states cited.
  
  
  CONCLUSIONS
  The rationale for use of antipsychotic drug therapy frequently relates to a wide variety of indications for which these drugs are not approved and for which evidence of efficacy is lacking. These findings have implications for clinical practice and policy.
authors: School of Nursing and Center for Health Policy, Northeastern University, Boston, Massachusetts.
authors: Alice F
authors: AF
authors: Bonner
authors: Terry S
authors: TS
authors: Field
authors: Celeste A
authors: CA
authors: Lemay
authors: Kathleen M
authors: KM
authors: Mazor
authors: Daniel A
authors: DA
authors: Andersen
authors: Christina J
authors: CJ
authors: Compher
authors: Jennifer
authors: J
authors: Tjia
authors: Jerry H
authors: JH
authors: Gurwitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005190:Family / Q000523:psychology*; D005260:Female; D006276:Health Facility Size; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D009735:Nursing Homes; D056687:Off-Label Use; D011908:Rationalization
chemical_list: D014150:Antipsychotic Agents
keywords: antipsychotic medication; dementia; nursing home