Tuesday, May 10, 2011

OIG: Overstating the impact of antipsychotic drugs in America's nursing homes

by Dr. David Gifford
Senior Vice President, Quality & Regulatory Affairs at AHCA

The Health and Human Services Office of the Inspector General just issued a report that raises a number of questions about the use of antipsychotic drugs in nursing facility patients many with Alzheimer’s and other forms of dementia. Speaking as a geriatrician, I know that we can do more to reduce the number of patients in nursing homes that are on antipsychotic drugs, but this study oversimplifies the issues and implies greater misuse of these medications.

The majority of nursing home residents (86%) in this study from 2007 are not on antipsychotic drugs. Of the 14% receiving one of these mediations, only 22% were found to not meet CMS standards for medication administration (or 3% of all nursing home residents). Nonetheless, this is still too high a number and further efforts should focus on ways to manage nursing home residents with dementia and behavior problems without medications.

This study also found that when prescribed, these medications were given for so-called “off label” use 83% of the time. The use of medications for off label reasons is common practice. Off label use shouldn’t be misconstrued to mean inappropriate use.

I agree that we can do more to learn how to help our nursing home residents, in particular those with dementia with behavior issues. We need to look for ways to treat a person’s condition and behavior – ideally without medication. At AHCA, we will keep working with physicians, caregivers and family members to educate them on these issues and look for ways to improve the care for the 1.5 million Americans who need long-term services every day.

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