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Feds want unneeded
antipsychotic drugs for elderly cut by 15 percent
this year
By Thomas Goldsmith, New
Observer
May 30, 2012
Nursing-home residents with dementia are too often
treated with powerful, unnecessary antipsychotic
drugs, federal regulators said Wednesday, announcing a
national goal to reduce such prescriptions by 15
percent by Dec. 31.
The announcement came as a North Carolina coalition of
regulators, advocates, industry representatives and
others were gearing up a campaign aimed at the same
goal.
Marilyn Tavenner, acting chief of the Centers for
Medicare and Medicaid Services announced the
Partnership to Improve Dementia Care, involving
federal and state officials, long-term care providers
and advocacy groups and caregivers.
“I knew that Health and Human Services was going to
make a push, but I didn’t know it would be this big,”
said Bill Lamb, a former state health and human
services official involved with North Carolina’s
efforts against improper prescriptions.
The unnecessary use of anti-psychotic drugs such as
Risperdol to calm older residents can cause
significant mental and physical health problems, and
even carries an increased risk of death, years of
studies have shown. Federal data from 2010, the most
recent available, show that 17 percent of residents in
nursing homes were given daily doses of the drugs
beyond recommended levels.
“We want our loved ones with dementia to receive the
best care and the highest quality of life possible,”
Tavenner said.
In North Carolina, Bob Konrad with Families of
Residents in Long Term Care is applying for grant
funds to work on training and awareness with providers
and caregivers. Along with Durham ombudsman Carmelita
Karhoff, Lamb and Konrad want to form a partnership
with the state Medical Directors Association and the
Carolinas Center for Medical Excellence, a nonprofit
group that works with Medicare and Medicaid programs.
According to a statement, the federal program will
include:
• Enhanced training. Hand in Hand, a training
series for nursing homes, puts an emphasis on
“person-centered” care, or putting the needs of a
resident at the center of a treatment plan. It aims to
prevent abuse and ensure high-quality care. Also,
state and federal surveyors will get behavioral-health
training.
• Increased transparency. Each nursing home’s
use of antipsychotic drugs will be available online at
the Nursing Home Compare website, starting in July.
• Alternatives to antipsychotic drugs. The
program will push non-drug-based alternatives for
treating residents. Those can include consistent staff
assignments, increased exercise or time outdoors and
planning activities based on each resident’s needs and
likes. In addition, staff will put more focus on
monitoring and managing acute and chronic pain.
“A CMS nursing home resident report found that almost
40 percent of nursing home patients with signs of
dementia were receiving antipsychotic drugs at some
point in 2010, even though there was no diagnosis of
psychosis,” said Dr. Patrick Conway, chief medical
officer for the Centers for Medicare and Medicaid
Services.
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