Nursing Homes Using Fewer Antipsychotic Drugs, Study Finds

Nursing home use of antipsychotics is on the decline, according to new data released on Nursing Home Compare in July by CMS. Instead, nursing homes are concentrating on a more patient-centered approach to dementia and other behavioral health care as part of a nation-wide effort to improve dementia care in the past year.

Unnecessary antipsychotic drug use poses a significant challenge to nursing homes when treating patients diagnosed with dementia. According to CMS, in 2010, more than 17 percent of nursing home patients had daily doses exceeding recommended levels, and the number was increasing.

Partnership Goals

In response to the trend, CMS launched the National Partnership to Improve Dementia Care (Partnership) with the goal of reducing unnecessary antipsychotic drug use in nursing homes. The Partnership’s goal is to improve the quality of care and quality of life for the country’s 1.5 million nursing home residents. And part of this means to reduce antipsychotic drug usage by 15 percent by the end of 2013.

“This important partnership to improve dementia care in nursing homes is yielding results,” said Dr. Patrick Conway, CMS chief medical officer and director of the Center for Clinical Standards and Quality. “We will continue to work with clinicians, caregivers, and communities to improve care and eliminate harm for people living with dementia.”

Since its inception, the Partnership has made some great strides with its goals. The national prevalence of antipsychotic use in long stay nursing home residents has been reduced by 9.1 percent by the first quarter of 2013, compared to the last quarter of 2011. Currently, there are approximately 30,000 fewer nursing home residents on these medications now than if the prevalence had remained at the pre-National Partnership level. Eleven states have either reached or exceeded the targeted 15 percent reduction, while others are rapidly approaching the goal. Alabama, Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee and Vermont are among the states to reach the 15 percent reduction.

Methods of Reduction

There are several approaches the Partnership is using as methods to reduce the use of antipsychotics in nursing homes. Among them are enhanced training for nursing home providers and state surveyors; increased transparency by making antipsychotic use data available online at Nursing Home Compare; and highlighting alternate strategies to improve dementia care.