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
2018
Prescription Benzodiazepine Use Among Older Adults
Gerlach L, Wiechers I, Maust D. Prescription Benzodiazepine Use Among Older Adults. Harvard Review Of Psychiatry 2018, 26: 264-273. PMID: 30188338, PMCID: PMC6129989, DOI: 10.1097/hrp.0000000000000190.Peer-Reviewed Original ResearchConceptsUse of benzodiazepinesOlder adultsAvailable evidenceAnxiety disordersPsychological symptomsPlacebo-controlled trialPubMed/MEDLINETreatment of insomniaYears of ageImproved sleep outcomesBZD useFuture trialsPsychotropic medicationsBenzodiazepine useClinical indicationsChronic benzodiazepinesInclusion criteriaBehavioral disturbancesEligibility criteriaElectronic databasesSleep outcomesPsychiatric conditionsSystematic reviewTreatment alternativesBenzodiazepines
2017
National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care.
Maust DT, Blow FC, Wiechers IR, Kales HC, Marcus SC. National Trends in Antidepressant, Benzodiazepine, and Other Sedative-Hypnotic Treatment of Older Adults in Psychiatric and Primary Care. The Journal Of Clinical Psychiatry 2017, 78: e363-e371. PMID: 28448697, PMCID: PMC5408458, DOI: 10.4088/jcp.16m10713.Peer-Reviewed Original ResearchConceptsPrimary care providersPrimary carePain diagnosisCare providersOlder adultsClinical characteristicsNational Ambulatory Medical Care SurveyNon-Hispanic white patientsAmbulatory Medical Care SurveyMental healthCommon psychotropic medicationsOutpatient physician visitsPrimary care visitsUse of antidepressantsMental health treatmentCare visitsMedication usePhysician visitsWhite patientsPsychotropic medicationsCare SurveyPsychotropic useHealth treatmentVisit ratesAntidepressants
2016
Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer.
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer. Journal Of Opioid Management 2016, 12: 259-68. PMID: 27575827, DOI: 10.5055/jom.2016.0341.Peer-Reviewed Original ResearchConceptsPrescription opioid useVeterans Health Administration patientsOpioid useMetastatic cancerAnxiolytic medicationMedical indicationsMultivariate analysisMore emergency department visitsNational VHA dataEmergency department visitsPrescription of antidepressantsAnxiolytic prescriptionsOpioid prescriptionsDepartment visitsVHA patientsPsychotropic medicationsFiscal year 2012VHA dataDrug AdministrationMedicationsBipolar disorderCareful monitoringYounger ageAnxiolyticsCancer
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 ResearchConceptsPsychotropic 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