The Effects of Antipsychotic Quality Reporting on Antipsychotic and Psychoactive Medication Use

• Published in: Health services research Vol. 50; no. 4; pp. 1069 - 1087
• Main Authors: Bowblis, John R., Lucas, Judith A., Brunt, Christopher S.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.08.2015; Health Research and Educational Trust; John Wiley & Sons, Ltd
• Subjects: Analysis; Antidepressants; Antipsychotic agents; Antipsychotic Agents - therapeutic use; Antipsychotic drugs; Antipsychotics; Drug Utilization - statistics & numerical data; Drugs; Health care delivery; Health services; Homes for the Aged - statistics & numerical data; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - therapeutic use; Medical care; Medical care quality; Mental disorders; Nursing home compare; Nursing homes; Nursing Homes - statistics & numerical data; Practice Patterns, Physicians; Prescription drugs; psychoactive medications; Psychotropic drugs; Psychotropic Drugs - administration & dosage; Psychotropic Drugs - therapeutic use; public reporting; quality; Quality management; Quality of Care; Quality of Health Care; Studies; Nursing home compare; antipsychotics; psychoactive medications; public reporting; quality
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.12281

Objective The objective of this study is to examine how nursing homes changed their use of antipsychotic and other psychoactive medications in response to Nursing Home Compare's initiation of publicly reporting antipsychotic use in July 2012. Research Design and Subjects The study includes all state recertification surveys (n = 40,415) for facilities six quarters prior and post the initiation of public reporting. Using a difference‐in‐difference framework, the change in use of antipsychotics and other psychoactive medications is compared for facilities subject to public reporting and facilities not subject to reporting. Principal Findings The percentage of residents using antipsychotics, hypnotics, or any psychoactive medication is found to decline after public reporting. Facilities subject to reporting experienced an additional decline in antipsychotic use (−1.94 vs. −1.40 percentage points) but did not decline as much for hypnotics (−0.60 vs. −1.21 percentage points). Any psychoactive use did not vary with reporting status, and the use of antidepressants and anxiolytics did not change. Conclusion Public reporting of an antipsychotic quality measure can be an effective policy tool for reducing the use of antipsychotic medications—though the effect many only exist in the short run.