Letters reduce quetiapine use among nursing home patients, community-dwelling patients with dementia
By Elana Gotkine HealthDay Reporter
MONDAY, April 29, 2024 (HealthDay News) — For patients with dementia, letters warning primary care physicians (PCPs) regarding overprescribing can reduce quetiapine prescriptions, according to a study published online April 25 in JAMA Network Open.
Michelle Harnisch, from the London School of Economics and Political Science, and colleagues conducted a secondary analysis of a randomized clinical trial of overprescribing letters that began in April 2015 and involved the highest-volume PCP prescribers of quetiapine in original Medicare. PCPs were randomly assigned to receive a placebo letter or three overprescribing warning letters stating that their prescribing of quetiapine was high and under review (2,528 and 2,527 PCPs, respectively). These PCPs accounted for 84,881 patients with dementia living in nursing homes and 261,288 community-dwelling patients with dementia.
The researchers found that quetiapine use was reduced with the intervention among nursing home patients and community-dwelling patients (adjusted differences, −0.7 and −1.5 days, respectively). No adverse effects were observed on cognitive function, behavioral symptoms, depression, metabolic diagnoses, or more severe outcomes such as hospitalization and death.
“Our results highlight the value of simple deprescribing interventions for clinicians, specialty societies, and regulators seeking to improve the quality of dementia care,” the authors write. “Related interventions could promote guideline-concordant care more broadly.”
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