Instrumental variable applications using nursing home prescribing preferences in comparative effectiveness research.

ABSTRACT:

Purpose

Nursing home residents are of particular interest for comparative effectiveness research given their susceptibility to adverse treatment effects and systematic exclusion from trials. However, the risk of residual confounding because of unmeasured markers of declining health using conventional analytic methods is high. We evaluated the validity of instrumental variable (IV) methods based on nursing home prescribing preference to mitigate such confounding, using psychotropic medications to manage behavioral problems in dementia as a case study.

Methods

A cohort using linked data from Medicaid, Medicare, Minimum Data Set, and Online Survey, Certification and Reporting for 2001-2004 was established. Dual-eligible patients ≥65 years who initiated psychotropic medication u

SUBMITTER: Huybrechts KF 

PROVIDER: S-EPMC4116440 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature