Caregiver & Elder Care News
National Group Reduces Antipsychotic Drug Use in Nursing Homes, Sets New
National Partnership, including CMS, seeks to
optimize the quality of life in America’s nursing homes by improving
care for all residents, especially those with dementia
19, 2014 – After two years of success in reducing the use of
antipsychotic medications by patients in long-stay nursing home care,
the National Partnership to Improve Dementia Care today established a
new national goal of reducing the use by 25 percent by the end of 2015,
and 30 percent by the end of 2016. The public-private coalition includes
the Centers for Medicare & Medicaid Services (CMS), consumers, advocacy
organizations, providers and professional associations.
Between the end of 2011 and the end of 2013, the
national prevalence of antipsychotic use in long-stay nursing home
residents was reduced by 15.1 percent, decreasing from 23.8 percent to
20.2 percent nationwide.
“We know that many of the diagnoses in nursing
home residents do not merit antipsychotics but they were being used
anyway,” said Patrick Conway, M.D.,
deputy administrator for
innovation and quality and the CMS chief medical officer. “In
partnership with key stakeholders, we have set ambitious goals to reduce
use of antipsychotics because there are – for many people with dementia
– behavioral and other approaches to provide this care more effectively
Coalition members, including AMDA – The Society for
Post-Acute and Long-Term Care Medicine, American Health Care Association
(AHCA), LeadingAge and Advancing Excellence in America’s Nursing Homes,
are committed to achieving these new goals.
These goals build on the progress made to date and
express the coalition’s commitment to continue this important effort.
The National Partnership seeks to optimize the quality of life for
residents in America’s nursing homes by improving care for all
residents, especially those with dementia.
“We have created many tools for nursing homes to
use to help achieve these goals,” said Dr. Conway.
“Ultimately, nursing homes should re-think their
approach to dementia care, re-connect with the person and their
families, and use a comprehensive team-based approach to provide care.”
While the initial focus is on reducing the use of
antipsychotic medications, the Partnership’s larger mission is to
enhance the use of non-pharmacologic approaches and person-centered
dementia care practices. CMS will monitor the reduction of
antipsychotics as well as the possible consequences.
For example, CMS will review prescriptions of
anxiolytics and sedative/hypnotics to make sure nursing homes do not
just replace antipsychotics with other drugs.
In addition, CMS will review the cases of residents
whose antipsychotics are withdrawn to make sure they don’t suffer an
unnecessary decline in functional or cognitive status as a nursing home
tries to reduce its usage.
Some states have achieved significant reduction in
their rate of antipsychotic usage. For example, Georgia reduced its rate
by 26.4 percent and North Carolina saw a 27.1 percent reduction. CMS
fact sheet today with full state-by-state data as well as other data
from the program.
CMS and its partners are committed to finding new
ways to implement practices that enhance the quality of life for people
with dementia, protect them from substandard care and promote
goal-directed, person-centered care for every nursing home resident.
The Partnership has engaged the nursing home
industry across the country around reducing use of antipsychotic
medications with momentum and success in this area that is expected to
continue. In 2011, Medicare Part D spending on antipsychotic drugs
totaled $7.6 billion, which was the second highest class of drugs,
accounting for 8.4 percent of Part D spending.
In addition to posting a measure of each nursing
home’s use of antipsychotic medications on the CMS Nursing Home Compare
website, in the coming months CMS plans to add the antipsychotic measure
to the calculations that CMS makes for each nursing home’s rating on the
agency’s Five Star Quality Rating System.