Recent Research from University of Michigan Highlight Findings in Insurance (Variation In Benzodiazepine and Antipsychotic Prescribing Among Hospice Agencies): Insurance

2022 MAY 20 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Investigators discuss new findings in Insurance. According to news reporting originating from Ann Arbor, Michigan, by NewsRx correspondents, research stated, “Benzodiazepines and antipsychotics are routinely prescribed for symptom management in hospice. There is minimal evidence to guide prescribing in this population, and little is known about how prescribing varies across hospice agencies.”

Financial support for this research came from NIH National Institute on Aging (NIA).

Our news editors obtained a quote from the research from the University of Michigan, “Examine patient- and hospice agency-level characteristics associated with incident prescribing of benzodiazepines and antipsychotics in hospice. Retrospective cohort study of a 20% sample of Medicare beneficiaries newly enrolled in hospice. Medicare hospice beneficiaries >= 65 years old between 2014 and 2016, restricted to those without benzodiazepine (N = 169,688) or antipsychotic (N = 190,441) prescription fills in the 6 months before hospice enrollment. The primary outcome was incident (i.e., new) prescribing of a benzodiazepine or antipsychotic. A series of multilevel Cox regression models with random intercepts for hospice agency were fit to examine the association of incident benzodiazepine and antipsychotic prescribing with patient and hospice agency characteristics. A total of 91,728 (54.1%) and 58,175 (30.5%) hospice beneficiaries were newly prescribed an incident benzodiazepine or antipsychotic. The prescribing rate of the hospice agency was the strongest predictor of incident prescribing: Compared to patients in bottom-quartile benzodiazepine-prescribing agencies, those in top-quartile agencies were 10.7 times more likely to be prescribed an incident benzodiazepine (adjusted hazard ratio [AHR] 10.7, 95% CI 10.1-11.3). For incident antipsychotic prescribing, patients in top-quartile agencies were 51.7 times more likely to receive an antipsychotic (AHR 51.7, 95% CI 44.3-60.4) compared to those in the bottom quartile. Results remained consistent accounting for comfort kit prescribing. The pattern of benzodiazepine or antipsychotic prescribing of a hospice agency strongly predicts whether a hospice enrollee is prescribed these medications, exceeding every other patient-level factor.”

According to the news editors, the research concluded: “While the appropriate level of prescribing in hospice is unclear, this variation may reflect a strong local prescribing culture across individual hospice agencies.”

This research has been peer-reviewed.

For more information on this research see: Variation In Benzodiazepine and Antipsychotic Prescribing Among Hospice Agencies. Journal of General Internal Medicine, 2022. Journal of General Internal Medicine can be contacted at: Springer, One New York Plaza, Suite 4600, New York, Ny, United States. (Wiley-Blackwell - http://www.wiley.com/; Journal of General Internal Medicine - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1525-1497)

The news editors report that additional information may be obtained by contacting Lauren B. Gerlach, University of Michigan, Dept. of Psychiatry, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States. Additional authors for this research include Lan Zhang, Donovan T. Maust, Hyungjin Myra Kim, Julie P. W. Bynum, Julie Strominger and Joan Teno.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1007/s11606-022-07604-3. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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