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Exploring Antipsychotic Prescribing Behaviors for Nursing Home Residents With Dementia: A Qualitative Study

Overview of attention for article published in Journal of the American Medical Directors Association, November 2018
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

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105 tweeters

Citations

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12 Dimensions

Readers on

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112 Mendeley
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Title
Exploring Antipsychotic Prescribing Behaviors for Nursing Home Residents With Dementia: A Qualitative Study
Published in
Journal of the American Medical Directors Association, November 2018
DOI 10.1016/j.jamda.2018.07.004
Pubmed ID
Authors

Kieran A. Walsh, Carol Sinnott, Aoife Fleming, Jenny Mc Sharry, Stephen Byrne, John Browne, Suzanne Timmons

Abstract

Caution is advised when prescribing antipsychotics to people with dementia. This study explored the determinants of appropriate, evidence-based antipsychotic prescribing behaviors for nursing home residents with dementia, with a view to informing future quality improvement efforts and behavior change interventions. Semistructured qualitative interviews based on the Theoretical Domains Framework (TDF). A purposive sample of 27 participants from 4 nursing homes, involved in the care of nursing home residents with dementia (8 nurses, 5 general practitioners, 5 healthcare assistants, 3 family members, 2 pharmacists, 2 consultant geriatricians, and 2 consultant psychiatrists of old age) in a Southern region of Ireland. Using framework analysis, the predominant TDF domains and determinants influencing these behaviors were identified, and explanatory themes developed. Nine predominant TDF domains were identified as influencing appropriate antipsychotic prescribing behaviors. Participants' effort to achieve "a fine balance" between the risks and benefits of antipsychotics was identified as the cross-cutting theme that underpinned many of the behavioral determinants. On one hand, neither healthcare workers nor family members wanted to see residents over-sedated and without a quality of life. Conversely, the reality of needing to protect staff, family members, and residents from potentially dangerous behavioral symptoms, in a resource-poor environment, was emphasized. The implementation of best-practice guidelines was illustrated through 3 explanatory themes ("human suffering"; "the interface between resident and nursing home"; and "power and knowledge: complex stakeholder dynamics"), which conceptualize how different nursing homes strike this "fine balance." Implementing evidence-based antipsychotic prescribing practices for nursing home residents with dementia remains a significant challenge. Greater policy and institutional support is required to help stakeholders strike that "fine balance" and ultimately make better prescribing decisions. This study has generated a deeper understanding of this complex issue and will inform the development of an evidence-based intervention.

Twitter Demographics

The data shown below were collected from the profiles of 105 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 112 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 112 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 22 20%
Student > Bachelor 13 12%
Student > Ph. D. Student 13 12%
Student > Doctoral Student 10 9%
Researcher 9 8%
Other 20 18%
Unknown 25 22%
Readers by discipline Count As %
Nursing and Health Professions 21 19%
Medicine and Dentistry 18 16%
Psychology 13 12%
Social Sciences 6 5%
Pharmacology, Toxicology and Pharmaceutical Science 5 4%
Other 16 14%
Unknown 33 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 70. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 April 2020.
All research outputs
#366,978
of 17,464,602 outputs
Outputs from Journal of the American Medical Directors Association
#73
of 2,334 outputs
Outputs of similar age
#10,628
of 285,315 outputs
Outputs of similar age from Journal of the American Medical Directors Association
#3
of 73 outputs
Altmetric has tracked 17,464,602 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,334 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.3. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 285,315 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 73 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.