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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (10)
- Adverse Events (8)
- Arthritis (1)
- Asthma (1)
- Blood Clots (1)
- Blood Thinners (2)
- Cancer (2)
- Cancer: Breast Cancer (2)
- Cardiovascular Conditions (6)
- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Diabetes (2)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (1)
- Falls (1)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Heart Disease and Health (4)
- Hepatitis (1)
- Hospitalization (1)
- Injuries and Wounds (2)
- Long-Term Care (2)
- Medicaid (1)
- Medicare (1)
- (-) Medication (26)
- Medication: Safety (2)
- Mortality (2)
- Neurological Disorders (1)
- Nursing Homes (1)
- Opioids (3)
- Outcomes (3)
- Patient-Centered Outcomes Research (4)
- Patient Adherence/Compliance (1)
- Patient Safety (4)
- Practice Patterns (1)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- (-) Risk (26)
- Sleep Problems (1)
- Stroke (3)
- Substance Abuse (3)
- Treatments (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedZhang Y, Johnson P, Jeng PJ
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
This study examined the association between a first opioid prescription and high-risk opioid use in the 18 months following the first prescription. A retrospective cohort study was conducted using data from a large commercial insurance claims database for patients aged 18-64 and also Medicare Advantage patients aged 65 or older for 2011-2014. The patients initially had not used opioids. The features the researchers were looking for were: 1) opioid or benzodiazepine prescriptions overlapping 7 days or more, 2) opioid prescriptions overlapping for 7 days or more; 3) three or more prescribers of opioids; and 4) a daily dosage exceeding 120 morphine milligram equivalents, in each of the six quarters following the first prescription. All of those features were strongly associated with high-risk use.
AHRQ-funded; HS021531.
Citation: Zhang Y, Johnson P, Jeng PJ .
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
J Gen Intern Med 2018 Dec;33(12):2156-62. doi: 10.1007/s11606-018-4628-y..
Keywords: Opioids, Substance Abuse, Medication, Risk, Medicare, Health Insurance
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Samples H, Williams AR, Olfson M
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
The purpose of this study was to examine duration of buprenorphine treatment for opioid use disorder (OUD) following the initiation of treatment in order to identify risk factors for early discontinuation. Researchers analyzed insurance claims from the MarketScan multi-state Medicaid database for 2013 through 2015; their sample included adults aged 18-64 years who had an OUD diagnosis 6 months before initiating buprenorphine treatment. More than 1/4 of the sample discontinued buprenorphine in the first month of treatment, and most of the sample discontinued before 180 days. Risk factors for discontinuation were associated with significantly lower odds of treatment retention for at least 180 days. The study concludes that there is need to implement treatment models that address barriers to treatment retention more effectively.
AHRQ-funded; HS021112.
Citation: Samples H, Williams AR, Olfson M .
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
J Subst Abuse Treat 2018 Dec;95:9-17. doi: 10.1016/j.jsat.2018.09.001..
Keywords: Medicaid, Medication, Opioids, Risk, Substance Abuse
Desai RJ, Wyss R, Jin Y
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Use of disease risk score (DRS)-based confounding adjustment when estimating treatment effects on multiple outcomes is not well studied. In this empirical cohort study, the investigators compared dabigatran initiators and warfarin initiators with respect to risks of ischemic stroke and major bleeding in 12 sequential monitoring periods (90 days each), using data from the Truven Marketscan database (Truven Health Analytics, Ann Arbor, Michigan).
AHRQ-funded; HS022193.
Citation: Desai RJ, Wyss R, Jin Y .
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Am J Epidemiol 2018 Nov;187(11):2439-48. doi: 10.1093/aje/kwy130.
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Keywords: Blood Thinners, Cardiovascular Conditions, Medication, Outcomes, Research Methodologies, Risk, Stroke
Makris UE, Alvarez CA, Mortensen EM
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
This study examined the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, use-related injury, and undergoing rehabilitation in a cohort with longitudinal follow-up. Statin use was associated with a significant increased risk of non-traumatic arthropathies and use-related injury. The results provide additional data that can inform patient and clinician conversations about the benefits and risks of statin use.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Mortensen EM .
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
Drug Saf 2018 Oct;41(10):939-50. doi: 10.1007/s40264-018-0682-y..
Keywords: Arthritis, Medication, Risk
Murff HJ, Roumie CL, Greevy RA
Metformin use and incidence cancer risk: evidence for a selective protective effect against liver cancer.
Several observational studies suggest that metformin reduces incidence cancer risk; however, many of these studies suffer from time-related biases and several cancer outcomes have not been investigated due to small sample sizes. In this large cohort study that accounted for time-related biases, the researchers observed no association between the use of metformin and most cancers; however, they found a strong inverse association between metformin and liver cancer.
AHRQ-funded; 290050042.
Citation: Murff HJ, Roumie CL, Greevy RA .
Metformin use and incidence cancer risk: evidence for a selective protective effect against liver cancer.
Cancer Causes Control 2018 Sep;29(9):823-32. doi: 10.1007/s10552-018-1058-4..
Keywords: Cancer, Medication, Risk
Olfson M, Wall M, Wang S
Risks of fatal opioid overdose during the first year following nonfatal overdose.
This study examined that risks of fatal opioid overdose during the first year following nonfatal overdose. A national retrospective longitudinal cohort of patients- aged 18-64 years, in the Medicaid program, who received a clinical diagnosis of nonfatal opioid overdose-was identified. Repeated overdoses and fatal opioid overdoses were measured with the Medicaid record and the National Death Index and rates of repeat overdose per 1000 person-years and fatal overdose per 100,000 person-years were determined.
AHRQ-funded; HS023258; HS021112.
Citation: Olfson M, Wall M, Wang S .
Risks of fatal opioid overdose during the first year following nonfatal overdose.
Drug Alcohol Depend 2018 Sep 1;190:112-19. doi: 10.1016/j.drugalcdep.2018.06.004..
Keywords: Adverse Drug Events (ADE), Medication, Opioids, Risk
Flory JH, Keating SJ, Siscovick D
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
Non-persistence may be a significant barrier to the use of metformin. The objective of this study was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy. The investigators concluded that their data supported the routine prescribing of low starting doses of metformin as a tool to improve persistence.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating SJ, Siscovick D .
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
BMJ Open 2018 Jul 23;8(7):e021505. doi: 10.1136/bmjopen-2018-021505..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Outcomes, Patient-Centered Outcomes Research, Risk
Trivedi LU, Alvarez CA, Mansi IA
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
The objective of this study was to examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). The study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. The authors assert that clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
AHRQ-funded; HS022418.
Citation: Trivedi LU, Alvarez CA, Mansi IA .
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
Ann Pharmacother 2018 Jun;52(6):546-53. doi: 10.1177/1060028018756650..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Neurological Disorders, Risk
Liu W, Antonelli PJ, Dahm P
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
The objective of this retrospective cohort study was to determine the risk of sudden sensorineural hearing loss (SNHL) associated with use of phosphodiesterase type 5 (PDE5) inhibitors. The investigators found that use of PDE5 inhibitors was associated with a small but significantly increased risk of sudden SNHL.
AHRQ-funded; HS021112.
Citation: Liu W, Antonelli PJ, Dahm P .
Risk of sudden sensorineural hearing loss in adults using phosphodiesterase type 5 inhibitors: population-based cohort study.
Pharmacoepidemiol Drug Saf 2018 Jun;27(6):587-95. doi: 10.1002/pds.4405..
Keywords: Risk, Adverse Drug Events (ADE), Adverse Events, Medication, Patient Safety
Westover AN, Nakonezny PA, Halm EA
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. The investigators concluded that in their cohort comorbid substance use disorders were common and were risk factors for development of (AUD).
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Halm EA .
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
Addiction 2018 May;113(5):857-67. doi: 10.1111/add.14122..
Keywords: Substance Abuse, Medication, Risk, Mortality, Patient-Centered Outcomes Research, Outcomes
Chen Y, Lairson DR, Chan W
Risk of adverse events associated with front-line anti-myeloma treatment in Medicare patients with multiple myeloma.
This study aims to examine the risks of adverse events associated with anti-multiple myeloma (MM) therapies in a large population-based cohort of elderly patients with MM. It found that novel agents significantly increased the risk of anemia, peripheral neuropathy, and thromboembolic events. Combination therapies consisting of proteasome inhibitor plus immunomodulatory drugs were associated with significantly higher risk for anemia, neutropenia and thromboembolic events.
AHRQ-funded; HS018956.
Citation: Chen Y, Lairson DR, Chan W .
Risk of adverse events associated with front-line anti-myeloma treatment in Medicare patients with multiple myeloma.
Ann Hematol 2018 May;97(5):851-63. doi: 10.1007/s00277-018-3238-4.
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Keywords: Adverse Drug Events (ADE), Cancer, Treatments, Medication, Risk
Sun D, Simon GJ, Skube S
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
Cardiotoxicity is a relatively common and particularly important adverse event caused by chemotherapy for breast cancer patients. The authors of this study propose three phenotyping algorithms to assess breast cancer patients' susceptibility to cardiotoxicity caused by five first-line antineoplastic drugs. The study demonstrates the potential utility of causal phenotyping.
AHRQ-funded; HS022085.
Citation: Sun D, Simon GJ, Skube S .
Causal phenotyping for susceptibility to cardiotoxicity from antineoplastic breast cancer medications.
AMIA Annu Symp Proc 2018 Apr 16;2017:1655-64..
Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Risk
Dore DD, Zullo AR, Mor V
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
This study examined the rate of hip fracture in nursing home residents prescribed nonbenzodiazepine hypnotics. A sample of nursing home residents was used and linked to Medicare and Minimum Data Set (2007-2008) data. The rate of hip fracture was higher in residents aged 90 and above, and lower in residents 70 or below. There was no different by sex.
AHRQ-funded; HS022998.
Citation: Dore DD, Zullo AR, Mor V .
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
J Am Med Dir Assoc 2018 Apr;19(4):328-32.e2. doi: 10.1016/j.jamda.2017.09.015..
Keywords: Injuries and Wounds, Medication, Nursing Homes, Long-Term Care, Adverse Drug Events (ADE), Adverse Events, Falls, Risk, Patient Safety
Rangachari P
Implementing a Social Knowledge Networking (SKN) system to enable meaningful use of an EHR medication reconciliation system.
The study examined user-engagement in the SKN system and associations between "SKN use" and "meaningful use" of electronic health record (EHR). The prospective implementation design is expected to generate context-sensitive strategies for meaningful use and successful implementation of EHR Medication Reconciliation (MedRec) and thereby make substantial contributions to the patient safety and risk management literature.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Implementing a Social Knowledge Networking (SKN) system to enable meaningful use of an EHR medication reconciliation system.
Risk Manag Healthc Policy 2018 Mar 26;11:45-53. doi: 10.2147/rmhp.s152313.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Safety, Risk
Lopes RD, Rordorf R, De Ferrari GM
Digoxin and mortality in patients with atrial fibrillation.
This study examined whether digoxin was independently associated with mortality in patients with atrial fibrillation (AF). Digoxin is a widely used medication for AF. The association was assessed in 17,897 patients who were score-matched with control participants. Baseline digoxin was not associated with increased mortality, but patients with a serum digoxin concentration of greater or equal to 1.2 ng/ml had a 56% increased hazard of mortality.
AHRQ-funded; HS024310.
Citation: Lopes RD, Rordorf R, De Ferrari GM .
Digoxin and mortality in patients with atrial fibrillation.
J Am Coll Cardiol 2018 Mar 13;71(10):1063-74. doi: 10.1016/j.jacc.2017.12.060..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Heart Disease and Health, Medication, Mortality, Risk
Smith I, Schmidt R, Halm EA
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
The aim of this study was to examine the association of statins with esophageal conditions. The study concluded that statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.
AHRQ-funded; HS022418.
Citation: Smith I, Schmidt R, Halm EA .
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
Clin Drug Investig 2018 Feb;38(2):135-46. doi: 10.1007/s40261-017-0589-x..
Keywords: Adverse Drug Events (ADE), Heart Disease and Health, Medication, Patient-Centered Outcomes Research, Risk
Leonard CE, Han X, Brensinger CM
Comparative risk of serious hypoglycemia with oral antidiabetic monotherapy: a retrospective cohort study.
The purpose of this study was to examine and compare risks of serious hypoglycemia among antidiabetic monotherapy-treated adults receiving metformin, a sulfonylurea, a meglitinide, or a thiazolidinedione. The investigators found that sulfonylureas were associated with the highest rates of serious hypoglycemia. Among all study drugs, the highest rate was seen with glyburide. Pioglitazone was associated with a lower adjusted hazard for serious hypoglycemia vs metformin, while rosiglitazone and nateglinide had hazards similar to that of metformin.
AHRQ-funded; HS023898.
Citation: Leonard CE, Han X, Brensinger CM .
Comparative risk of serious hypoglycemia with oral antidiabetic monotherapy: a retrospective cohort study.
Pharmacoepidemiol Drug Saf 2018 Jan;27(1):9-18. doi: 10.1002/pds.4337..
Keywords: Risk, Adverse Drug Events (ADE), Adverse Events, Diabetes, Medication
Safford MM, Barasch A, Curtis JR
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
This study examined associations between bisphosphonate use and nontraumatic subtrochanteric (NTST) femoral fractures and hip fractures in the Veterans Health Administration. It found that nontraumatic subtrochanteric femoral fractures were uncommon, and longer bisphosphonate use was associated with lower (not higher) risk. In men, risks of NTST femoral fractures associated with bisphosphonate treatment may be low in contrast to substantial protective benefits for hip fracture.
AHRQ-funded; HS016956; HS018517.
Citation: Safford MM, Barasch A, Curtis JR .
Bisphosphonates and hip and nontraumatic subtrochanteric femoral fractures in the Veterans Health Administration.
J Clin Rheumatol 2014 Oct;20(7):357-62. doi: 10.1097/rhu.0000000000000170..
Keywords: Elderly, Injuries and Wounds, Risk, Medication, Adverse Events
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
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Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities
Schelleman H, Han X, Brensinger CM
Pharmacoepidemiologic and in vitro evaluation of potential drug-drug interactions of sulfonylureas with fibrates and statins.
This study examined whether initiation of fibrates or statins in sulfonylurea users is associated with hypoglycemia and in vitro inhibition of cytochrome P450 (CYP) enzymes by statins, fenofibrate and glipizide. It found that use of fenofibrate or gemfibrozil together with glyburide was associated with
elevated overall risks of serious hypoglycemia.
elevated overall risks of serious hypoglycemia.
AHRQ-funded; HS019818.
Citation: Schelleman H, Han X, Brensinger CM .
Pharmacoepidemiologic and in vitro evaluation of potential drug-drug interactions of sulfonylureas with fibrates and statins.
Br J Clin Pharmacol 2014 Sep;78(3):639-48. doi: 10.1111/bcp.12353..
Keywords: Comparative Effectiveness, Medication, Risk
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk
Goldsweig AM, Reid KJ, Gosch K
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
The authors examined dual antiplatelet therapy (DAPT) use in contemporary clinical practice after publication of the results of the landmark randomized clinical trial CHARISMA. They found that use of DAPT is modest in patients with established cardiovascular disease, for whom the CHARISMA trial suggested decreased major adverse cardiovascular events (MACEs), and prescription rates have remained stable over time; use of DAPT in patients with multiple risk factors only, for whom CHARISMA suggested that DAPT may lead to increased MACEs, was low and decreased over time.
AHRQ-funded; HS018781.
Citation: Goldsweig AM, Reid KJ, Gosch K .
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
Am J Manag Care 2014 Aug;20(8):659-65.
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Keywords: Cardiovascular Conditions, Medication, Prevention, Practice Patterns, Risk
Majid A, McAninch J, Morgan DJ
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
This study aimed to assess early treatment discontinuation rates and identify underlying risk factors for discontinuation in a real-world boceprevir-based treatment cohort. Nearly half of patients started on boceprevir-based hepatitis C triple therapy stopped treatment by 24 weeks, with more discontinuing because of treatment intolerance than virologic failure. Early discontinuation was significantly more common in patients with comorbidities.
AHRQ-funded; HS018111.
Citation: Majid A, McAninch J, Morgan DJ .
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
J Viral Hepat 2014 Aug;21(8):585-9. doi: 10.1111/jvh.12201.
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Keywords: Hepatitis, Adverse Events, Medication, Risk
Aparasu RR, Chatterjee S, Chen H
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
This study examined the risk of all-cause hospitalization among dual-eligible elderly nursing home residents who were using antipsychotic medications and found that, on average, there was a 58 percent increase in hospitalization risk after 20 days of using a first-generation drug.
AHRQ-funded; HS016920
Citation: Aparasu RR, Chatterjee S, Chen H .
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
Psychiatr Serv. 2014 Jun;65(6):781-8. doi: 10.1176/appi.ps.201300093..
Keywords: Long-Term Care, Medication, Hospitalization, Elderly, Risk