Nursing Homes Often Medicate Residents Without Psychosis
"In recent years, Medicaid has spent more money on antipsychotic drugsfor Americans than on any other class of pharmaceuticals," largelybecause nursing homes are "giving these drugs to elderly patients toquiet 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 psychosisare prescribed antipsychotic drugs. "The growing off-label use ofantipsychotic medicines in the elderly is coming under fire fromregulators, academics, patient advocates and even some in the nursinghome 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 facilitieswhere you see residents slumped over in their wheelchairs, their headsare hanging, and they're out of it, and that is unacceptable."According to Teigland, her research shows about one-third of dementiapatients in nursing homes in New York state are receivingantipsychotics, with some facilities dispensing the drugs at rates ashigh as 60% to 70% of patients.
The nursing home industry oftenuses the drugs to "try to calm dementia patients and to maintain safetyand order in their facilities," the Journal reports. The Journalnotes that the "economics of elderly care can work in favor of drugsbecause federal insurance programs reimburse more readily for pills"than for the extra staff that would be needed to care for dementiapatients 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 distressingsymptoms of dementia -- or trying to find other ways to help" elderlypatients with dementia or Alzheimer's (Lagnado, Wall Street Journal, 12/4).
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