Unregulated Use of Antipsychotic Drugs in Nursing Home Facilities

Blue Capsules on a Prescription FormDespite an initiative to reduce the use of antipsychotic medications in nursing homes, the use of antipsychotic drugs has not significantly decreased. In 2012, the Centers for Medicare and Medicaid Services (CMS) raised concern about the amount of antipsychotic medications being used in U.S. nursing home facilities.

So far, the decrease has been unsatisfactory to those at the CMS, and in some New York facilities, the use of antipsychotic drugs have even increased. The CMS wanted to reduce use of the psychotic drugs due to the dangers related to excessive and unnecessary dosage, which includes patient falls, accidents, and death.

In May of 2012, the CMS set a goal of reducing the drug use by 15 percent, but still had not reached that goal a year later. However, advocates for the decrease claim that the goal was modest in the first place. “We were concerned because we didn’t think that 15 percent was enough of a reduction.

So not even being able to reach that mark is of great concern to us,” said Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care. Grant holds the nursing home facilities responsible for the meager goal, stating, “the 15 percent was something that the nursing home industry put out there and proposed.

My guess would be they were putting it at a rate that they thought they could accomplish, which just underscores how disappointing it is and how troubling it is that they didn’t achieve their own goal.”

The main issue with the use of antipsychotic drugs is that they are being used “off-label,” meaning to treat unapproved diagnoses. Many U.S. nursing homes use antipsychotics to treat dementia and alzheimers, including related conditions such as agitation, aggression, and hallucinations in the elderly.

Doctor Taking Pulse Of Senior Male Patient In Bed At HomeCurrently, there are no drugs approved by the U.S. Food and Drug Administration (FDA) to treat dementia, alzheimers, and related conditions. Use of antipsychotic medications is linked to risks like diabetes, pneumonia, stroke, movement disorders that can become permanent, and sudden cardiac death.

The FDA also associates antipsychotic drug use to dizziness, dangerous drops in blood pressure, abnormal heart beats, blurred vision, and urinary problems in the elderly. Despite the amount and severity of the risks, reports found that more than 1 in 5 nursing home facilities in the U.S. treated patients with antipsychotics, with no approved diagnosis that warranted use of the drugs.

What’s more, in 2010 it was found that about 185,000 nursing home patients were administered antipsychotics, thought prescribing the drugs goes against federal nursing home recommendations. In 2012, the CMS reported that the rise of unwarranted drug use in nursing homes marks a significant change in how cases of dementia and alzheimers are treated.

Many nursing home residents in these cases suffer from dementia and alzheimers and are treated with the antipsychotics, which are intended for those suffering from schizophrenia.

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