Rate of Antipsychotic Prescribing in Nursing Homes Drops

Antipsychotic drugs are an important treatment for patients with
certain mental health conditions, such as schizophrenia. But the Food and Drug
Administration has warned that the drugs have potentially fatal side effects
when used in elderly patients with dementia. Still, nursing homes use the drugs
"off-label" to calm patients who are agitated or confused. Concerned
about the drugs' overuse, federal regulators last year announced a national
initiative to slash their inappropriate use in nursing homes, with a goal of a
15 percent reduction by the end of 2012. A new study shows that the
prescription rates have dropped in recent months. Nationally, the use of
antipsychotics dropped 9 percent — short of the goal — to an average of 21.7
percent. But CMS touts the drop as evidence that many nursing homes are
pursuing more patient-centered treatments for dementia, such as behavioral
interventions. Eleven states hit or exceeded the 15 percent target, including
Maine, North Carolina, Rhode Island, and Vermont. Some of those states have
made antipsychotic reduction a priority. Other states that have made
significant progress have undertaken training programs that teach nursing home
workers alternatives to drugs. In North Carolina, for example, the Carolinas
Center for Medical Excellence partnered with the state ombudsman program to
train 205 nursing home leaders in patient-centered care practices, such as
consistent assignment of nurses' aides, and to educate physicians about
reducing antipsychotic use. A subset of facilities that received onsite
training and monitoring reduced antipsychotic medications by 66 percent,
according to the American Health Quality Association. Federal regulations now
mandate that nursing home residents not be started on antipsychotics unless
they have specific diagnoses of psychosis or related conditions, and that
facilities make gradual dose reductions for those already receiving the drugs.

Source/more: Hartford Courant

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