Wednesday, March 4, 2015

GAO Report: Government Should Expand Efforts to Reduce Antipsychotic Drug Use in Other Settings

Meg La Porte

In a report released on Monday, the Government Accountability Office (GAO) found that antipsychotic drugs are frequently prescribed to older adults with dementia. GAO's analysis found that among Medicare Part D enrollees with dementia living outside of a nursing center in 2012, about 14 percent were prescribed an antipsychotic.

GAO also found that about one-third of older adults with dementia who spent more than 100 days in a nursing center in 2012 were prescribed an antipsychotic.

The GAO says:

"Agencies within the Department of Health and Human Services (HHS) have taken several actions to address antipsychotic drug use by older adults in nursing homes, as described in HHS's National Alzheimer's Plan; however, none have been directed to settings outside of nursing homes, such as assisted living facilities or individuals' homes. While the National Alzheimer's Plan has a goal to improve dementia care for all individuals regardless of residence, HHS officials said that efforts to reduce antipsychotic use have not focused on care settings outside nursing homes, though HHS has done work to support family caregivers in general. Stakeholders GAO spoke to indicated that educational efforts similar to those provided for nursing homes should be extended to other settings. Extending educational efforts to caregivers and providers outside of the nursing home could help lower the use of antipsychotics among older adults with dementia living both inside and outside of nursing homes."

NCAL is already leading the charge to address this issue outside of nursing centers, as the GAO recommends. The NCAL Quality Initiative has a three-year goal to safely reduce the off-label use of antipsychotic medications by 15% by March 2015.

AHCA members have lowered antipsychotic use by an average of 21% since 2011, which means 62,000 people are no longer receiving these medicines. Skilled nursing facilities hope to lower usage by another 15% by end of 2016.

The agency formally recommended that the Secretary of HHS should expand its outreach and educational efforts aimed at reducing antipsychotic drug use among older adults with dementia to include those residing outside of nursing homes by updating the National Alzheimer's Plan.

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