2022
Evaluation of Antipsychotic Reduction Efforts in Patients With Dementia in Veterans Health Administration Nursing Homes
Gerlach LB, Maust DT, Kales HC, Chang M, Kim HM, Wiechers IR, Zivin K. Evaluation of Antipsychotic Reduction Efforts in Patients With Dementia in Veterans Health Administration Nursing Homes. American Journal Of Psychiatry 2022, 179: 544-552. PMID: 35615813, PMCID: PMC9349465, DOI: 10.1176/appi.ajp.21060591.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCNS-active medicationsVHA Nursing HomesNursing homesAnxiolytic prescribingOverall prescribingVeterans Health Administration nursing homesNursing home patientsNursing home residentsInterrupted time series designAntipsychotic reductionQuarterly prevalenceMedication classesOpioid medicationsAntidepressant prescribingAntipsychotic useMedication prescribingHome patientsPsychotropic medicationsLabel useHome residentsSimilar riskMedicationsPrescribingHealth Administration
2021
Impact of an interdisciplinary intervention for distress behaviors in dementia on psychotropic drug use in Veterans Health Administration Community Living Centers STAR-VA impact on psychotropic drug utilization
McConeghy KW, Curyto K, Jedele J, Intrator O, Mohr DC, Wiechers IR, Karel MJ. Impact of an interdisciplinary intervention for distress behaviors in dementia on psychotropic drug use in Veterans Health Administration Community Living Centers STAR-VA impact on psychotropic drug utilization. Geriatric Nursing 2021, 42: 1533-1540. PMID: 34739929, DOI: 10.1016/j.gerinurse.2021.10.009.Peer-Reviewed Original ResearchConceptsPsychotropic drug useDrug useVeterans Health Administration nursing homesPsychotropic medication usePsychotropic drug utilizationDistress behaviorsSTAR-VAMedication usePsychotropic useDrug utilizationCohort analysisNursing homesInterdisciplinary interventionEligible residentsStudy designTreatment effectsDementiaImportant optionResidentsBehavioral approachCasesAverage reductionDosesMonthsTrends in Medication Prescribing in Patients With PTSD From 2009 to 2018: A National Veterans Administration Study.
Holder N, Woods A, Neylan TC, Maguen S, Seal KH, Bernardy N, Wiechers I, Ryder A, Urbieta AM, Cohen BE. Trends in Medication Prescribing in Patients With PTSD From 2009 to 2018: A National Veterans Administration Study. The Journal Of Clinical Psychiatry 2021, 82 PMID: 34004087, DOI: 10.4088/jcp.20m13522.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntipsychotic AgentsDrug PrescriptionsHumansLongitudinal StudiesMaleMiddle AgedPractice Patterns, Physicians'Psychotropic DrugsRetrospective StudiesSelective Serotonin Reuptake InhibitorsSerotonin and Noradrenaline Reuptake InhibitorsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderPercentage of patientsVeterans Health AdministrationVHA careAdjunctive medicationsOutpatient prescription recordsSSRIs/SNRIsVeterans Administration studyClinical practice guidelinesICD-10 codesAdverse side effectsEvidence-based psychotherapiesPsychotic spectrum disordersAAP useMedication classesBenzodiazepine prescriptionsMedication prescribingPrescription recordsSymptom improvementNational cohortPractice guidelinesMedicationsSide effectsICD-9Patients
2015
Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration. Psychiatry Research 2015, 227: 324-332. PMID: 25863822, DOI: 10.1016/j.psychres.2015.03.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Anxiety AgentsAntidepressive AgentsDrug PrescriptionsFemaleHumansHypnotics and SedativesMaleMental DisordersOpioid-Related DisordersPrevalencePsychotropic DrugsSleep Initiation and Maintenance DisordersUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsMental health clinicsPsychotropic medicationsOpioid prescriptionsHealth clinicsMedical indicationsAnxiolytics/sedatives/hypnoticsLong-term opioid useSpecialty mental health clinicsService use correlatesRelated adverse eventsSedative/hypnoticsVeterans Health AdministrationMental health treatmentAdverse eventsOpioid useHarmful side effectsFiscal year 2012More psychotropicsSide effectsPsychiatric diagnosisHealth treatmentMedicationsHealth AdministrationPsychotropicsAnxiety disorders
2013
Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis
Wiechers IR, Leslie DL, Rosenheck RA. Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis. Psychiatric Services 2013, 64: 1243-1248. PMID: 23999894, DOI: 10.1176/appi.ps.201200557.Peer-Reviewed Original ResearchConceptsMental health specialty carePotential medical indicationsProportion of patientsPsychotropic medicationsPsychiatric diagnosisSpecialty careMedical indicationsComorbid medical conditionsGeneral medical illnessMajority of recipientsOlder patientsYounger patientsMedical illnessClaims databaseResults AltogetherDesirable careMedical conditionsMedicationsPatientsMultivariate analysisPrivate insuranceDiagnosisCareFurther studiesSeverityIncreased Risk Among Older Veterans of Prescribing Psychotropic Medication in the Absence of Psychiatric Diagnoses
Wiechers IR, Kirwin PD, Rosenheck RA. Increased Risk Among Older Veterans of Prescribing Psychotropic Medication in the Absence of Psychiatric Diagnoses. American Journal Of Geriatric Psychiatry 2013, 22: 531-539. PMID: 24211029, DOI: 10.1016/j.jagp.2013.10.007.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overFemaleHumansMaleMental DisordersMiddle AgedPsychotropic DrugsRisk FactorsUnited StatesVeteransConceptsPsychotropic medicationsPsychiatric diagnosisOlder veteransNational VHA administrative dataAge groupsOverall medical comorbidityVHA administrative dataLogistic regression analysisDiabetes medicationsMedical comorbiditiesVHA patientsEncounter claimsMedicationsMedical indicationsMental illnessMultivariate analysisMental healthcareFiscal year 2010Unnecessary useDiagnosisIncomplete documentationVeteransHIVStrongest predictorRegression analysis