Nursing Homes Often Medicate Residents Without Psychosis

Main Category: Seniors / Aging
Also Included In: Mental Health;  Caregivers / Homecare
Article Date: 05 Dec 2007 - 9:00 PDT

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"In recent years, Medicaid has spent more money on antipsychotic drugs for Americans than on any other class of pharmaceuticals," largely because nursing homes are "giving these drugs to elderly patients to quiet symptoms of Alzheimer's disease and other forms of dementia" -- conditions for which the drugs are not approved by FDA, the Wall Street Journal reports. According to CMS, 21% of nursing home residents who do not have a diagnosis of psychosis are prescribed antipsychotic drugs. "The growing off-label use of antipsychotic medicines in the elderly is coming under fire from regulators, academics, patient advocates and even some in the nursing home industry," the Journal reports.

Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging -- a not-for-profit industry group -- said, "You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they're out of it, and that is unacceptable." According to Teigland, her research shows about one-third of dementia patients in nursing homes in New York state are receiving antipsychotics, with some facilities dispensing the drugs at rates as high as 60% to 70% of patients.

The nursing home industry often uses the drugs to "try to calm dementia patients and to maintain safety and order in their facilities," the Journal reports. The Journal notes that the "economics of elderly care can work in favor of drugs because federal insurance programs reimburse more readily for pills" than for the extra staff that would be needed to care for dementia patients without the use of drugs.

U.S. sales of antipsychotics last year reached $11.7 billion, up from $6.6 billion in 2002, data from IMS Health show. According to the Journal, the "big question" for nursing homes is "whether to use a medical model -- administering antipsychotics as the way to alleviate distressing symptoms of dementia -- or trying to find other ways to help" elderly patients with dementia or Alzheimer's (Lagnado, Wall Street Journal, 12/4).

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