Tuesday, August 27, 2013

Antipsychotic Use Drops in Nursing Homes, but 2013 Goal Not Yet Reached

Use of antipsychotics in nursing homes for dementia and other conditions has fallen since the start of a new government program, according to data from the Centers for Medicare and Medicaid Services (CMS) reported today in The Lund Report, a health care newsletter.

In 2012, CMS  launched the National Partnership to Improve Dementia Care in response to data showing that more than 17% of nursing home patients had daily dosages of antipsychotics exceeding recommended levels. The partnership’s goal is to reduce antipsychotic drug usage by 15% by the end of 2013. The new data show the national prevalence of antipsychotic use in long-stay nursing home residents had been reduced by 9.1% by the first quarter of 2013, compared with the last quarter of 2011.

At least 11 states have hit or exceeded a 15% target, and others are approaching that goal. States that have met or exceeded the target are Alabama, Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee and Vermont.

Geriatric psychiatrist and immediate past APA President Dilip Jeste, M.D., said the use of antipsychotics in nursing home patients is a complicated issue. "On one hand, a number of patients with dementia have severe psychotic symptoms that impact their well-being and overall management, and these need treatment," he told Psychiatric News. "On the other hand, there are no FDA-approved medications for psychosis in people with dementia, and the available medications, including antipsychotics, have significant side effects. The real solution to this dilemma would be improving the standard of care in nursing homes and making data-based psychosocial interventions a part of regular treatment.”

For more on the partnership see the Psychiatric News article "Dementia Patients Likely to Receive Fewer Antipsychotics."

(Image: Alexander Rath/shutterstock.com)


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