To the Editor.
—One of the most significant findings cited by Dr Shorr and colleagues1 is that having more nursing personnel results in a greater ability to decrease the use of neuroleptic drugs. This is a finding of profound importance. It suggests that if legislators wish to decrease the use of these drugs, one way to do so is to increase staffing. It also suggests that some nursing homes in Tennessee are understaffed and, perhaps, that the greater use of these drugs is necessary when there is low staffing. Unfortunately, the importance of this finding was obscured by the authors' emphasis on the effect that the Omnibus Budget Reconciliation Act of 1987 (OBRA-87) had on physicians' prescribing habits.Staffing may be an intervening variable that affects much of the drug use data in the study. One might suppose that if Tennessee nursing home staffs were being bolstered during or
Venable RJ. Legislating Drug Prescribing Practices. JAMA. 1994;272(1):30. doi:10.1001/jama.1994.03520010040021