Use of Antipsychotic Medications Drops since Start of CMS Initiative

When a person must decide on a nursing home, or their loved ones must choose one for them, there are so many factors and considerations that go into making that crucial and life-impacting decision. One of the many pieces of criteria should be the nursing home’s record of use of antipsychotic drugs to control and subdue residents. The use of antipsychotic drugs in the past was a more commonplace and accepted way to restrain patients, especially those who suffered from some type of psychosis, dementia or Alzheimer’s and could become easily irritable or even violent.

However, the use of such medications has come to be considered an improper form of chemical restraint by so many, as it can cause irreversible physical and/or mental damage, push the patient into a drug dependency, or into a hard cycle of uppers, suppressants and other medications in between. Medical providers, including nursing home doctors and nurses, have also typically used these drugs because of the ease of administering them rather than taking alternative, more humane and chemical-free methods.

Due to the adverse effects of using antipsychotic medications, there has been a growing and progressive movement to push nursing homes and long-term care facilities to re-educate and re-train staff about the dangers of antipsychotic drugs, and about preferred methods to aid patients with problems previously met with just drugs. In recent years, the federal government through the Centers for Medicare and Medicaid Services which administers those insurance programs nationally for the elderly and the poor, has created its own initiative to reduce the use of antipsychotic medications. The initiative centers on “enhancing person-centered care for nursing home residents, particularly those with dementia-related behaviors,” and has relied on improving “public reporting, raising public awareness, regulatory oversight, technical assistance/training and research.”

This initiative seeks to involve public agencies and private healthcare providers in making these changes. None of this is to say that antipsychotic medication use should be eliminated entirely, as certain dire circumstances could require it. But certainly the overuse and unnecessary use must be curbed in order to improve patient health, and to avoid the secondary concern of medical providers submitting reimbursement claims for such unnecessary use, which could be fraud.

Latest Report on Drug Usage in Nursing Homes

In recent news, the rate of use of antipsychotic drugs has reportedly decreased, even better than the goals initially set by CMS. In a three year period, which dates back to the start of the CMS initiative, the rate of use of antipsychotic medications has decreased almost 20%. According to the National Partnership to Improve Dementia Care in Nursing Homes, as cited in a article on this development, between the fourth quarter of 2011 and the third quarter of 2014 (thus three years), the percentage of residents in long-term care facilities given antipsychotic medication dropped from nearly 24% to just over 19%. And according to that article, the American Health Care Association aims to decrease unnecessary use by an additional 10% in 2015.

This news is highly encouraging and demonstrates how institutions and agencies can make such changes when there is enough consensus and initiative to do so. Additionally, as part of the government’s efforts to reform its rating system, which is published on the Nursing Home Compare website for consumer use, it now includes rate of antipsychotic drug use in measuring the quality of nursing homes. Inclusion of this metric further demonstrates its importance, and consumers can now pay particular attention to it when researching nursing homes that are reviewed on this site.

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