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Editor's Correspondence
January 28, 2008

It Is Time to Assess the Role of Organizational Culture in Nursing Home Prescribing Patterns

Arch Intern Med. 2008;168(2):238-239. doi:10.1001/archinternmed.2007.43

We read the recent article by Rochon et al1 with a heavy heart. That 1 in 3 Canadian nursing home (NH) residents receives an antipsychotic medication is alarming. Although cross-national comparisons of antipsychotic use indicate significant variation by country,2 the Canadian findings suggest a similar situation to the one in the United States. The introduction of atypical antipsychotics sets off a dramatic increase in the use of these medications in NHs, but the recent evidence on their risks3 leaves us wondering how it is possible that 20 years after the Omnibus Budget Reconciliation Act of 1987 we have come full circle to the same spot.