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A recent study published in JAMA Network Open sheds light on concerning disparities in antipsychotic medication use in nursing homes, particularly in disadvantaged communities. The research, led by Jasmine Travers, assistant professor at NYU Rory Meyers College of Nursing, highlights the influence of staffing levels and neighborhood socioeconomics on medication practices in long-term care facilities.
Antipsychotic medications are commonly prescribed to nursing home residents, often to manage behavioral issues. However, their use without appropriate diagnosis poses significant risks, including an increased likelihood of falls, strokes, and other adverse outcomes. Recognizing these dangers, there has been a push to reduce antipsychotic use, particularly in cases where they may not be medically necessary.
Travers and her team delved into data from over 10,000 nursing homes across the U.S., including nearly 1,900 facilities located in severely disadvantaged neighborhoods. By examining staffing levels and neighborhood socioeconomics, they aimed to understand the factors influencing antipsychotic prescribing practices.
Their findings revealed troubling trends. Nursing homes in disadvantaged neighborhoods, especially those with inadequate staffing—defined as less than three hours of nurse staffing per resident each day—exhibited higher rates of antipsychotic medication use. In these understaffed facilities, residents were more likely to receive antipsychotics even without a qualifying diagnosis, compared to homes in more affluent areas.
The implications are significant. Not only does overmedication put residents at risk, but it also underscores broader issues of healthcare disparities and access to quality care in disadvantaged communities. Travers emphasizes the need for targeted interventions, including increased funding and staffing support for nursing homes in lower-income areas.
The study underscores the importance of addressing staffing deficiencies and implementing tailored interventions to mitigate the overuse of antipsychotics. By understanding the underlying vulnerabilities, policymakers can work towards equitable solutions that support nursing homes in disinvested communities and prioritize the well-being of all residents.
As efforts continue to improve long-term care practices, initiatives aimed at reducing medication misuse and enhancing resident care must take into account the intersecting factors of staffing levels and neighborhood socioeconomics. Through collaborative action, we can strive to create safer and more equitable environments for nursing home residents across the country.
