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Decrease of Anticholinergic Drug Use in Nursing Home Residents in the United States, 2009 to 2017
Ioannis Malagaris1, Hemalkumar B Mehta2, Shuang Li1
1Sealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas.
Anticholinergic drug use in nursing homes decreased significantly from 2009 to 2017. This decline was more rapid in higher-rated quality nursing homes, indicating improved prescribing practices.
Area of Science:
- Gerontology
- Pharmacology
- Health Services Research
Background:
- Anticholinergic drugs are commonly prescribed to nursing home residents.
- These medications carry risks, including cognitive impairment.
- Understanding trends in their use is crucial for resident safety.
Purpose of the Study:
- To analyze the time trends of anticholinergic drug use in nursing home residents.
- To determine if changes in anticholinergic use differed based on nursing home quality ratings.
Main Methods:
- Retrospective analysis of Medicare claims data (2009-2017).
- Inclusion of long-term residents aged 65+ in Medicare-certified nursing homes.
- Used Anticholinergic Cognitive Burden scale to identify high-activity drugs and logistic regression to analyze trends.
Main Results:
- Anticholinergic drug prescription rates decreased from ~35% in 2009-2011 to 24.3% in 2017.
- The decline was more pronounced in nursing homes with higher quality ratings (4-5 stars).
- Rates dropped from 33.7% to 23.3% in high-quality homes versus 34.2% to 25.2% in lower-quality homes.
Conclusions:
- Overall use of high anticholinergic activity drugs in nursing homes declined between 2009 and 2017.
- Higher-quality nursing homes demonstrated a more significant reduction in anticholinergic prescribing.
- Quality ratings appear to correlate with improved medication management for these drugs.
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