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Use of Antipsychotic Drugs to Treat Dementia Continues to Drop

August 13, 2015

The use of antipsychotic drugs to treat dementia continues to decline in U.S. nursing homes, new data (pdf) from the Centers for Medicare and Medicaid Services (CMS) shows.

In the first quarter of 2015, only 18.7 percent of long-stay nursing home residents were administered antipsychotic drugs to treat their dementia, CMS reports. The data was gathered through CMS’s National Partnership to Improve Dementia Care in Nursing Homes initiative.

That represents a significant decline from the first quarter of 2012, when 23.8 residents were administered antipsychotic drugs, the report shows.

“Historically, antipsychotic medications have been used to treat resident ‘behaviors’ that the staff don’t understand,” said PHI National Director of Coaching & Consulting Services Susan Misiorski.

“There is a growing body of evidence-based practice that helps us understand that resident ‘behaviors’ such as hitting, kicking, spitting, and yelling are actually self-protective,” she added. “In other words, the resident is trying to protect him or herself from staff interventions that they are simply not able to tolerate.”

CMS launched the National Partnership initiative in May 2012, with a stated goal of promoting “person-centered, comprehensive and interdisciplinary” care that would protect nursing homes residents from “being prescribed antipsychotic medications unless there is a valid, clinical indication and a systematic process to evaluate each individual’s need.”

The initiative is a vital step toward improving quality of care and quality of life in nursing homes, Misiorski said.

“With truly individualized care, staff who care for the same residents each time they work learn to understand the messages behind resident behaviors, and learn how to prevent them from happening at all,” she said.

“With greater awareness of the side effects of antipsychotics, and greater awareness of individualized care practices, fewer providers need to turn to antipsychotic administration as an intervention,” she added.

The rate at which antipsychotic drugs are administered to nursing home residents has declined in each quarter since CMS launched its National Partnership initiative.

Over the same span, 49 states have also seen their antipsychotic drug use decrease. The exception, Alaska, has one of the 10 lowest rates of antipsychotic drug use in the country, at just 14.4 percent.

Hawaii had the lowest such rate in the first quarter of 2015, at 10.9 percent, while Texas led the country in antipsychotic drug use (23.17 percent).

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