Do Nursing Home Prescribing Patterns Influence Antipsychotic Use in Assisted Living?

September 13, 2021

The use of antipsychotic medications in nursing homes (NHs) has come under intense scrutiny in recent years. A new study in the September issue of JAMDA suggests that reducing antipsychotic drug use in NHs may influence some assisted living (AL) practices.

In To What Extent Do Local Nursing Home Prescribing Patterns Relate to Psychotropic Prescribing in Assisted Living?, the authors found that rates of potentially inappropriate antipsychotic use in ALs weren’t associated with rates in the nearest or farthest NHs. However, being affiliated with a NH was associated with a lower rate of potentially inappropriate antipsychotic use. As for antianxiety medications, rates of the use of these drugs were significantly associated with the rates of neighboring NHs.

The authors also found that rates of antipsychotic and antianxiety prescribing in ALs vary by state. For instance, Texas was among the top two states in its rates of prescribing of both types of medications; Louisiana was the lowest. “The variation in rates of prescribing may be a function of the underlying population in these communities; or the regulations pertaining to medication administration and care of residents with dementia and mental health diagnoses,” the authors observed.

The study’s findings suggest that the increased focus on reducing antipsychotic medication use that has occurred in NHs has spilled over to affiliated AL communities. At the same time, the authors concluded, chain membership may reflect a higher degree of corporate standardization and oversight that is more salient to how medications are used in long-term care settings than local physician prescribing patterns.

The study was conducted by researchers at Brown University School of Public Health, Providence, RI; U.S. Department of Veterans Affairs Medical Center, Providence, RI; University of North Carolina, Chapel Hill, NC; Portland State University, Portland, OR; and American Health Care Association/National Center for Assisted Living, Washington, DC.

Click here for more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email



JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.

About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.