title: Antipsychotic prescribing patterns in a Medicare Advantage population of older individuals with dementia.
abstract: BACKGROUND
  Antipsychotic medications are widely used to treat behavioral symptoms of dementia. However, studies have shown that antipsychotic use in patients with dementia is associated with risk of side effects.
  
  
  OBJECTIVE
  The aim of this study is to examine antipsychotic prescribing patterns for beneficiaries with dementia enrolled in a Medicare Advantage program and identify opportunities to improve prescribing practices.
  
  
  METHODS
  This study includes Medicare Advantage beneficiaries who were 65 years of age or older with dementia. We examined the number of participants that were prescribed an antipsychotic medication. Descriptive analysis was performed, and logistic regression models were used to describe the correlates of antipsychotic exposure.
  
  
  RESULTS
  Of the 8688 individuals in the Medicare Advantage population with a dementia diagnosis, 1061 (12.2%) received an antipsychotic medication. Correlates of receiving an antipsychotic medication included older age, dual eligibility for Medicare and Medicaid, and having a co-morbid diagnosis of depressive disorder or substance use disorder. Being female was associated with decreased antipsychotic medication use. Regional variations were also noted.
  
  
  CONCLUSIONS
  Care management programs under Medicare Advantage have opportunities to address behavioral health needs of older adults with dementia and to limit inappropriate use of antipsychotic medications.
authors.affiliation: a Department of Psychiatry , Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kester
authors.affiliation: b Department of Psychiatry and Behavioral Sciences , University of Washington School of Medicine , Seattle , WA , USA , and.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
authors.affiliation: c Humana Cares , St. Petersburg , FL , USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Hogan
authors.affiliation: a Department of Psychiatry , Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA.
authors.forename: Hsiang
authors.initials: H
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D020398:Medicare Part C / Q000706:statistics & numerical data*; D020380:Needs Assessment; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D014481:United States
chemical_list: D014150:Antipsychotic Agents
keywords: Medicare; antipsychotics; dementia; elderly; geriatric