Katherine Winter
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View article: Long-stay gabapentin increases explained: A national nursing home clinician survey on prescribing intent
Long-stay gabapentin increases explained: A national nursing home clinician survey on prescribing intent Open
CONTEXT: Much conjecture but little hard data exists to explain why gabapentin prescribing in nursing homes (NHs) has doubled in the last decade. Gabapentin, an anti-seizure medication, is approved to treat partial seizures as well as post…
View article: Understanding Long-Stay Gabapentin Use Increases: A National Nursing Home Clinician Survey on Prescribing Intent
Understanding Long-Stay Gabapentin Use Increases: A National Nursing Home Clinician Survey on Prescribing Intent Open
Clinicians perceive gabapentin as safer than the drugs it is replacing. Whether this is true remains unclear; the individual- and population-level risks of increased gabapentin use are largely unknown.
View article: Understanding Pandemic Increases in Long-Stay Psychotropic Prescribing for Dementia Symptoms: A Survey of Nursing Home Clinicians
Understanding Pandemic Increases in Long-Stay Psychotropic Prescribing for Dementia Symptoms: A Survey of Nursing Home Clinicians Open
Objective: To explore the perceptions of nursing home (NH) clinicians regarding factors underpinning known increases in psychotropic prescribing over the COVID-19 pandemic. Methods: Three iterative online surveys were fielded to Virginia N…
View article: Quality Gap in Long-Stay Antipsychotic Quality Measure Performance Widens Over the Pandemic, Reversing Past Gains
Quality Gap in Long-Stay Antipsychotic Quality Measure Performance Widens Over the Pandemic, Reversing Past Gains Open
The Centers for Medicare & Medicaid Services (CMS) grades nursing home performance in antipsychotic prescribing quarterly, publishing findings as a quality measure. While scores have improved since 2011, marked performance variation betwee…
View article: Understanding stubborn antipsychotic prescribing in nursing homes: An environmental scan of National Partnership stakeholders
Understanding stubborn antipsychotic prescribing in nursing homes: An environmental scan of National Partnership stakeholders Open
CONTEXT: Since CMS debuted the National Partnership to Improve Dementia Care in Nursing Homes (NHs), antipsychotic (AP) prescribing in NHs has decreased. Reductions have stalled in recent years however, and more than one in six NH resident…
View article: A logic model to delineate the outcomes, consequences, and QI implications of CMS’s National Partnership
A logic model to delineate the outcomes, consequences, and QI implications of CMS’s National Partnership Open
CONTEXT: The National Partnership to Improve Dementia Care in Nursing Homes (NP) engages multiple stakeholder groups and impacts others. To facilitate ongoing improvement in long-stay dementia care, we set out to assess the perspectives of…
View article: Nursing home clinicians increased prescribing of all psychotropic medications for dementia symptoms over the pandemic
Nursing home clinicians increased prescribing of all psychotropic medications for dementia symptoms over the pandemic Open
CONTEXT: Staff shortages, loss of family/community supports, and isolation protocols have impeded nursing home (NH) dementia symptom management during Covid-19. OBJECTIVE: To explore the impact of the COVID-19 pandemic on the medication an…
View article: Prescribing trends and associated outcomes of antiepileptic drugs and other psychotropic medications in US nursing homes: A mixed-method investigation incorporating a secondary data analysis of multiple CMS datasets and a clinician survey
Prescribing trends and associated outcomes of antiepileptic drugs and other psychotropic medications in US nursing homes: A mixed-method investigation incorporating a secondary data analysis of multiple CMS datasets and a clinician survey Open
Background: Pilot data suggests off-label unmonitored antiepileptic drug (AED) prescribing for behavioral and psychological symptoms of dementia is increasing, replacing other psychotropic medications targeted by purposeful reduction effor…
View article: Trends in Antiseizure Medication Prescribing Among Nursing Home Residents With and Without a Seizure Diagnosis
Trends in Antiseizure Medication Prescribing Among Nursing Home Residents With and Without a Seizure Diagnosis Open
Objectives: Evaluate current prevalence and changes in prescribing of antiseizure medications (ASMs) in Virginia nursing homes for residents with and without seizures. Methods: Retrospective cohort. De-identified claims extracted from the …
View article: Selective Admission Decisions and Quality-Measure Scores in Desirable, Highly Resourced Nursing Homes
Selective Admission Decisions and Quality-Measure Scores in Desirable, Highly Resourced Nursing Homes Open
CONTEXT: Nursing homes are graded for quality, with antipsychotic use a key quality-measure contributing to CMS’s ‘5 Star’ facility rating. Some nursing homes have drastically improved their antipsychotic quality-measure score, while other…
View article: Community, Social, and Facility Factors and Long-stay Antipsychotic Use
Community, Social, and Facility Factors and Long-stay Antipsychotic Use Open
The efficacy of measures aimed at curbing long-stay antipsychotic prescribing could be improved by addressing SDOH including economic opportunities.
View article: Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia
Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia Open
PCPs continue to prescribe medications because they meet patient-oriented goals and because PCPs perceive drugs, including antipsychotics and their alternatives, to be more effective and less dangerous than evidence suggests. To optimally …