2022
Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study
Maust DT, Takamine L, Wiechers IR, Blow FC, Bohnert ASB, Strominger J, Min L, Krein SL. Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study. The Annals Of Family Medicine 2022, 20: 328-335. PMID: 35879067, PMCID: PMC9328717, DOI: 10.1370/afm.2825.Peer-Reviewed Original ResearchConceptsAverage daily doseDaily doseOlder adultsVeterans Health AdministrationHealth care facilitiesCommunity-based settingsLorazepam equivalentsAppropriate prescribingPrescribing practicesBZD prescribingBZD treatmentOlder veteransCare facilitiesMethods studyHealth AdministrationPotential patientsBenzodiazepinesPrescribingPatient identificationIndividualized recommendationsMixed-methods studyAdultsCliniciansDoseVeteransEvaluation 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
Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study
Lei L, Strominger J, Wiechers IR, Kim HM, Blow FC, Bohnert ASB, Min L, Krein SL, Maust DT. Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study. Journal Of General Internal Medicine 2021, 36: 3689-3696. PMID: 34047924, PMCID: PMC8642498, DOI: 10.1007/s11606-021-06780-y.Peer-Reviewed Original ResearchConceptsBZD prescriptionOlder veteransBZD prescribingHigher oddsPart DVeterans Affairs Health Care SystemRetrospective cohort studyPart D coverageMedicare Part D prescriptionsSubstance use disordersHealth care systemDesignRetrospective cohortPrescription prevalenceQuarterly prevalenceBenzodiazepine prescribingPart D prescriptionsCohort studyPatient characteristicsBZD useUse disordersFacility variationOlder agePrescribingBZDCare systemTrends 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
2020
Benzodiazepine Use among Medicare, Commercially Insured, and Veteran Older Adults, 2013–2017
Maust DT, Kim HM, Wiechers IR, Ignacio RV, Bohnert ASB, Blow FC. Benzodiazepine Use among Medicare, Commercially Insured, and Veteran Older Adults, 2013–2017. Journal Of The American Geriatrics Society 2020, 69: 98-105. PMID: 32951209, PMCID: PMC7856043, DOI: 10.1111/jgs.16825.Peer-Reviewed Original Research
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
No End in Sight: Benzodiazepine Use in Older Adults in the United States
Maust DT, Kales HC, Wiechers IR, Blow FC, Olfson M. No End in Sight: Benzodiazepine Use in Older Adults in the United States. Journal Of The American Geriatrics Society 2016, 64: 2546-2553. PMID: 27879984, PMCID: PMC5173408, DOI: 10.1111/jgs.14379.Peer-Reviewed Original ResearchConceptsMental health diagnosesBenzodiazepine useBenzodiazepine usersOlder adultsNonpsychiatrist physiciansNational Ambulatory Medical Care SurveyVisit ratesAmbulatory Medical Care SurveyAnnual visit rateHealth diagnosisEffective alternative treatmentCross-sectional analysisPatient ageOutpatient encountersClinical mental health diagnosisCare SurveyVisit characteristicsChronic usersAlternative treatmentYoung adultsVisitsDecades of evidenceOverall proportionAdultsSafety concerns
2015
Growing Use of Mental and General Health Care Services Among Older Veterans With Mental Illness
Wiechers IR, Karel MJ, Hoff R, Karlin BE. Growing Use of Mental and General Health Care Services Among Older Veterans With Mental Illness. Psychiatric Services 2015, 66: 1242-1244. PMID: 26278225, DOI: 10.1176/appi.ps.201400370.Peer-Reviewed Original ResearchConceptsHealth care servicesOlder veteransElectronic medical recordsMental illnessCare servicesMedical recordsVeterans Health Administration electronic medical recordsVHA electronic medical recordsGeneral health care servicesVeterans ages 65Health service utilizationMental health needsService utilizationService useHealth needsAge 65IllnessVeteransNational dataProportion
2013
Increased 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
2008
Behavioral observations reflected on consultation requests from primary medical-surgical services: Are they predictive of delirium diagnosis and outcomes?
Xiong GL, Wiechers IR, Bourgeois JA, Gagliardi JP. Behavioral observations reflected on consultation requests from primary medical-surgical services: Are they predictive of delirium diagnosis and outcomes? Journal Of Psychosomatic Research 2008, 66: 177-181. PMID: 19154861, DOI: 10.1016/j.jpsychores.2008.08.003.Peer-Reviewed Original ResearchConceptsMedical-surgical teamConsultation requestsHighest likelihood ratioDiagnosis of deliriumSystemic medical conditionsFinal clinical diagnosisMedical-surgical servicesClassification of patientsLower mortality rateDelirium subtypesLikelihood ratioReadmission ratesClinical outcomesDEP groupDelirium outcomesDelirium diagnosisMultivariate regression modelCognitive dysfunctionMedical conditionsPsychosomatic servicesDeliriumConsult requestsMortality rateBehavior disturbancesPatients