Table 2.
Strength of Instrumental Variables Based on Nursing Home Prescribing Preference in Predicting Psychotropic Medication Use for Individual Nursing Home Residents
Unadjusted | Adjusted(a) | |||||
---|---|---|---|---|---|---|
Risk Difference(b) | 95% CI | Semi-Partial R2 | Risk Difference(c) | 95% CI | Semi-Partial R2 | |
Antidepressants versus Atypical APMs(d) | ||||||
IV1: Median groups (lowest vs. highest quantile) | 0.325 | 0.306, 0.343 | 0.107 | 0.223 | 0.215, 0.231 | 0.057 |
IV2: Tertile groups (lowest vs. highest quantile) | 0.385 | 0.364, 0.406 | 0.150 | 0.279 | 0.269, 0.288 | 0.085 |
IV3: Quartile groups (lowest vs. highest quantile) | 0.397 | 0.374, 0.421 | 0.161 | 0.309 | 0.299, 0.319 | 0.103 |
Antidepressants versus Hypnotics | ||||||
IV1: Median groups (lowest vs. highest quantile) | 0.261 | 0.251, 0.270 | 0.068 | 0.248 | 0.241, 0.256 | 0.062 |
IV2: Tertile groups (lowest vs. highest quantile) | 0.329 | 0.318, 0.339 | 0.108 | 0.316 | 0.308, 0.324 | 0.100 |
IV3: Quartile groups (lowest vs. highest quantile) | 0.370 | 0.358, 0.382 | 0.137 | 0.356 | 0.347, 0.365 | 0.128 |
Atypical APMS versus Hypnotics | ||||||
IV1: Median groups (lowest vs. highest quantile) | 0.327 | 0.308, 0.346 | 0.110 | 0.226 | 0.218, 0.234 | 0.060 |
IV2: Tertile groups (lowest vs. highest quantile) | 0.392 | 0.371, 0.413 | 0.158 | 0.286 | 0.278, 0.295 | 0.091 |
IV3: Quartile groups (lowest vs. highest quantile) | 0.407 | 0.384, 0.431 | 0.173 | 0.320 | 0.310, 0.330 | 0.112 |
Adjusted for propensity score including all resident and facility characteristics
1-stage Model: X = α0 + α1Z + ε, with X=exposure and Z=IV
1-stage Model: X = α0 + α1Z + α2PS + ε, with X=exposure, Z=IV, and PS=propensity score
For the antidepressant versus atypical APM comparison, the risk difference represents the probability of being prescribed an antidepressant if residing in a nursing home with a preference for antidepressants (i.e., NH in highest quantile) relative to the probability of being prescribed an antidepressant if residing in a nursing home with a preference for atypical APMs (i.e., NH in lowest quantile) represented by α1 in the Model. The interpretation is similar for the other comparisons.