Use of antipsychotic drugs cut in nursing homes

Georgia has reduced its use of antipsychotic medications on nursing home residents by 26 percent, one of the largest drops in the nation.

smslogo

The decrease, occurring from the end of 2011 to the end of 2013, was powered in part by a pilot program targeting the Georgia nursing homes that had the highest use of antipsychotics.

Nationally, the prevalence of these drugs in long-stay nursing home patients dropped by 15 percent over that period, federal officials announced last week.

The federal Centers for Medicare and Medicaid Services has pushed for a decrease in the use of antipsychotics in managing dementia patients in nursing homes.

The medications increase the risk of death, falls with fractures, hospitalizations and other complications for nursing home residents, leading to high medical high costs, experts say.

In 2011, Medicare Part D spending on antipsychotic drugs totaled $7.6 billion. That was second-highest outlay for any class of drugs, accounting for 8.4 percent of Part D spending.

The National Partnership to Improve Dementia Care, a public-private coalition that includes CMS, consumer groups and medical providers, has called for further reduction of antipsychotics.

Mark Parkinson, CEO of the American Health Care Association, a national nursing home trade group that’s a member of the partnership, said, “There is more that can be accomplished.”

Of the national drop in the use of the medications, “the results speak for themselves,” Parkinson said. “Thousands of lives are being improved.”

Dr. Adrienne Mims
Dr. Adrienne Mims

Georgia had one of the highest rates of use of antipsychotics in 2011. Only Louisiana and Tennessee exceeded Georgia’s rate of 28.9 percent of patients.

But a six-month pilot project among 33 nursing homes in the state led to a 34 percent drop in antipsychotic use among patients in those facilities, said Dr. Adrienne Mims, medical director of Alliant GMCF, the Medicare “Quality Improvement Organization” for Georgia.

A number of groups collaborated in cutting Georgia’s use of antipsychotics, said Mims, who is also president of the American Health Quality Association.

“Improving dementia care will help improve quality of health and improve quality of life for all of our patients,” she said.

Jon Howell, president and CEO of the Georgia Health Care Association, said in a statement Monday, “The progress skilled nursing centers have made has been tremendous, but we know there is more work to be done.”

“After seeing the strides long-term care professionals in Georgia have already made to address this issue, we are confident we can continue to build upon our success and further improve the lives of Georgians living with dementia,”  Howell said.

Georgia now ranks 36th among states in use of antipsychotics for long-term stay nursing home residents. The lower the number, the less such drugs are being used.

Kathy Floyd, executive director of the Georgia Council on Aging, noted Georgia’s improvement.

“But North and South Carolina are sixth and seventh, so Georgia needs to be doing more,” Floyd added.