Use of antipsychotic drugs in nursing homes

Current compliance with OBRA regulations

Maria D. Llorente, Edwin J. Olsen, Oscar Leyva, Michael A. Silverman, John E Lewis, Jesus Rivero

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

OBJECTIVE: To examine the degree and patterns of compliance with the Omnibus Budget Reconciliation Act (OBRA) regulations regarding the use of antipsychotic drugs in nursing homes. DESIGN: Retrospective chart review of all resident records. PARTICIPANTS: Eight nursing homes: five community, two county-owned, and one university-affiliated Veterans Administration facility. MEASUREMENTS: A structured assessment instrument to track compliance with each aspect of the OBRA regulations regarding antipsychotic drug use. RESULTS: A total of 1573 nursing home residents' pharmacy records were reviewed between August 1994 and March 1996. Two hundred seventy-nine residents were actively taking antipsychotic medications (prevalence = 17.7%). Mean compliance greater than 70% was found for (1) appropriate diagnostic indication (X̄ = 70.9%), (2) dosage within recommended limits (X̄ = 90.1%), and 3) documented appropriate target symptoms (X̄ = 90.4%). Dosages were more likely to exceed limits in those patients with histories of major mental illness, particularly schizophrenia. CONCLUSIONS: Nursing homes were better able to comply with those guidelines that are most specific. Educational interventions now need to focus on behavioral interventions, monitoring of adverse effects, and efficacy. These data are useful in establishing threshold levels of performance and can be used by nursing homes for continuous quality improvement. OBRA continues to impact neuroleptic drug prescribing practices in nursing homes significantly.

Original languageEnglish
Pages (from-to)198-201
Number of pages4
JournalJournal of the American Geriatrics Society
Volume46
Issue number2
StatePublished - Jan 1 1998

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Budgets
Nursing Homes
Antipsychotic Agents
Drug Prescriptions
United States Department of Veterans Affairs
Quality Improvement
Schizophrenia
Guidelines

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Llorente, M. D., Olsen, E. J., Leyva, O., Silverman, M. A., Lewis, J. E., & Rivero, J. (1998). Use of antipsychotic drugs in nursing homes: Current compliance with OBRA regulations. Journal of the American Geriatrics Society, 46(2), 198-201.

Use of antipsychotic drugs in nursing homes : Current compliance with OBRA regulations. / Llorente, Maria D.; Olsen, Edwin J.; Leyva, Oscar; Silverman, Michael A.; Lewis, John E; Rivero, Jesus.

In: Journal of the American Geriatrics Society, Vol. 46, No. 2, 01.01.1998, p. 198-201.

Research output: Contribution to journalArticle

Llorente, MD, Olsen, EJ, Leyva, O, Silverman, MA, Lewis, JE & Rivero, J 1998, 'Use of antipsychotic drugs in nursing homes: Current compliance with OBRA regulations', Journal of the American Geriatrics Society, vol. 46, no. 2, pp. 198-201.
Llorente MD, Olsen EJ, Leyva O, Silverman MA, Lewis JE, Rivero J. Use of antipsychotic drugs in nursing homes: Current compliance with OBRA regulations. Journal of the American Geriatrics Society. 1998 Jan 1;46(2):198-201.
Llorente, Maria D. ; Olsen, Edwin J. ; Leyva, Oscar ; Silverman, Michael A. ; Lewis, John E ; Rivero, Jesus. / Use of antipsychotic drugs in nursing homes : Current compliance with OBRA regulations. In: Journal of the American Geriatrics Society. 1998 ; Vol. 46, No. 2. pp. 198-201.
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