Geriatrics Commons^™

Do Antipsychotic Dose Reduction Trials Result In Worsening Behavior Among Nursing Home Residents With Dementia: A Systematic Review Of The Literature, Jennifer Tjia, Abir O. Kanaan, Jennifer L. Donovan

Jennifer Tjia

Background: While federal regulations require gradual dose reduction trials of antipsychotics prescribed for behavior management in nursing home (NH) residents with dementia, widespread concern about precipitating behavioral disturbances limits implementation. We conducted a systematic review of clinical trials reducing antipsychotic drug use in NH residents to determine best dose reduction practices and risk of behavior escalation.

Methods: A comprehensive literature search was conducted in MEDLINE, EMBASE, and International Pharmaceutical Abstracts between January 1970 and October 2011 using the terms “antipsychotic agent or neuroleptic agent,” “dementia,” “nursing homes,” and “withdrawal.” One investigator reviewed abstracts for inclusion based on: English-language, …

Knowledge Of And Perceived Need For Evidence-Based Educational Materials About Antipsychotic Medication Safety By Nursing Home Staff, Celeste A. Lemay, Sarah Foy, Kathleen M. Mazor, Leslie R. Harrold, Jennifer L. Donovan, Abir O. Kanaan, Becky A. Briesacher, Jerry H. Gurwitz, Jennifer Tjia

Jennifer Tjia

Background: Given the widespread overuse of antipsychotic medications among US nursing home (NH) residents, we sought to identify knowledge of and perceived need for the AHRQ Comparative Effectiveness Research Summary Guide (CERSG) “Off-Label Use of Atypical Antipsychotic Drugs”.

Methods: We conducted a baseline needs assessment with 12 NHs participating in a randomized controlled trail evaluating evidence dissemination strategies. Using a mixed method approach, we conducted in-depth assessments of knowledge, attitudes, and practice behavior using telephone interviews with NH leadership (administrators, directors of nursing [DON], and medical directors), and questionnaires with NH leadership, consultant pharmacists and direct care staff. …

Technological Resources And Personnel Costs Required To Implement An Automated Alert System For Primary Care Physicians When Patients Transition From Hospitals To Home, Terry S. Field, Lawrence D. Garber, Shawn J. Gagne, Jennifer Tjia, Peggy Preusse, Jennifer L. Donovan, Abir O. Kanaan, Jerry H. Gurwitz

Jennifer Tjia

Background With the adoption of electronic medical records by medical group practices, there are opportunities to improve the quality of care for patients discharged from hospitals. However, there is little guidance for medical groups outside of integrated hospital systems to automate the flow of patient information during transitions in care.

Objective To describe the technological resources, expertise and time needed to develop an automated system providing information to primary care physicians when their patients transition from hospitals to home.

Development Within a medical group practice, we developed an automated alert system that provides notification of discharges, reminders of the need …