Nursing Home Antipsychotic Drug Use Often Unnecessary: Study
Federal investigators say that in recent years a little more than half of the antipsychotic medications prescribed in nursing homes were given to patients with dementia, who should not be given the powerful drugs. Use of the drugs is believed to have been spurred on by illegal kickback schemes from drug makers or as a form of chemical restraint by the nursing homes, despite the risk that use of antipsychotics could kill dementia patients.
Last week the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) released a report on atypical antipsychotic misuse in nursing homes.
Researchers say that 51% of prescriptions for drugs like Seroquel, Risperdal and Zyprexa in nursing homes during the first half of 2007 were given to dementia patients despite the known side effects of atypical antipsychotics. Taxpayers shelled out $116 million for the largely unnecessary prescriptions.
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Learn MoreThe powerful drugs are not approved for treatment of dementia, and the FDA has repeatedly warned that they should not be used to treat dementia patients, as the medications may increase the risk of death and many experts say that they do nothing to actually treat dementia.
Many critics have argued that the wide “off-label” prescriptions for nursing home dementia patients is really a form a “chemical restraint” for hard-to-manage residents, which is widely regarded as a form of nursing home abuse.
The HHS-OIG report took data collected by the U.S. Centers for Medicare and Medicaid Services (CMS) in the first half of 2007 and found that 14% of the nation’s 2.1 million elderly nursing home residents were prescribed atypical antipsychotics at least once. Medical records indicate that 83% of those drugs were given for “off-label” reasons which were not approved by the FDA. About 88% of the off-label uses were for conditions that the FDA cautioned against in black box warnings, the strongest label advisory the agency can give. The FDA warnings date back to 2005.
The HHS-OIG recommends that to prevent future abuses the CMS could use diagnosis information to ensure that it was not paying nursing homes to pharmaceutically abuse their residents. The report also includes recommendations that CMS analyze whether survey and certification processes can be changed to safeguard against the problems in the future and then hold nurses accountable when they distribute antipsychotics for the wrong reasons. The report also urged CMS to look at what other actions it can make to force compliance, and that the agency take action on the specific claims of misuse detailed in the report.
While CMS officials said they agreed with most of the recommendations, the agency stated it is impossible to determine whether the drug reimbursement claims meet payment requirements in a timely manner because diagnosis information is not required in pharmacy billing transactions and is not made part of the prescription.
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5 Comments
CathyFebruary 8, 2013 at 1:06 am
As a concerned daughter of a 93 y o Mom... And as a nurse who witnessed " chemical restraints" routinely used in nursing homes.... Truly, we all should be outraged at what is routinely prescribed for the victims ( yes, I use the word victim) of our medical communities!! Until we wake up to routine abuses like this article so clearly states... These types of elder abuse, chemical and physical [Show More]As a concerned daughter of a 93 y o Mom... And as a nurse who witnessed " chemical restraints" routinely used in nursing homes.... Truly, we all should be outraged at what is routinely prescribed for the victims ( yes, I use the word victim) of our medical communities!! Until we wake up to routine abuses like this article so clearly states... These types of elder abuse, chemical and physical restraints being used with no regard for a clients personal freedoms....I am glad that I got my Mom out of a facility and back to reside with me. It's wise to question why a medication is being used.... We must stand up for elderly in our lives... And honestly, visit clients at all hours in facilities so you are fully aware of what goes on there ... Be wary of any facility that wants to restrict visits!! Don't be afraid to question a doctors orders... Especially regarding anti psychotic or sedating drugs in any elderly client.
joeNovember 18, 2011 at 4:50 pm
Could you imagine what really could happen with obamacare. This one reason most people are against it. You try and do the right, by placing your father in home, and then this happen. It will get worst under the new health law. Even though the gov't says that they will use the best medicare for the elderly, they still have the right to do what they think is best. And if logic dictate that your fat[Show More]Could you imagine what really could happen with obamacare. This one reason most people are against it. You try and do the right, by placing your father in home, and then this happen. It will get worst under the new health law. Even though the gov't says that they will use the best medicare for the elderly, they still have the right to do what they think is best. And if logic dictate that your father is be on help, well you know the rest. Tax dollars will be held back.
jacquelineNovember 18, 2011 at 3:47 am
my father went into a nursing home and he was functioning well even thought he had dementia. university manor placed him on haldol without our consent and as a result he had a massive brain stroke at this time he almost in a vegetable state he cant talk at all he has a gtube inserted in his stomach he cant communicate with us at all it is heartbreaking. my question is to the government. if u are a[Show More]my father went into a nursing home and he was functioning well even thought he had dementia. university manor placed him on haldol without our consent and as a result he had a massive brain stroke at this time he almost in a vegetable state he cant talk at all he has a gtube inserted in his stomach he cant communicate with us at all it is heartbreaking. my question is to the government. if u are aware of whats happening to our elderly parents and grandparents what are you doing to help why are are elderly being use as ginny pigs. shame on u god will deal with u all in the worse way.
tammyOctober 16, 2011 at 4:03 am
My 83 yr old grandmother suffered congestive heart failure and was admitted to the hospital. She was there for a week the came home on oxygen. A week later she woke up throwing up blood and was rushed back. The doctors said she had a bleeding ulcer. They kept her for two weeks and never gave us a good answer on why she suddenly started talking out of her head, hallucinating and hearing things and [Show More]My 83 yr old grandmother suffered congestive heart failure and was admitted to the hospital. She was there for a week the came home on oxygen. A week later she woke up throwing up blood and was rushed back. The doctors said she had a bleeding ulcer. They kept her for two weeks and never gave us a good answer on why she suddenly started talking out of her head, hallucinating and hearing things and complaining of hurting from her head to her toes. They kept saying if the oxygen level was too low or too high that could happen. She was moved to a nursing home and we got the papers of the medicines the hospital had been giving her. Seraquel and Tramadone. I researched and the first thing that popped up for seraquel was Elderly patients with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) treated with this type of medicine are at an increased risk of death, compared to placebo (sugar pill). SEROQUEL XR and SEROQUEL are not approved for treating these patients. We have also told the nurses and doctors repeatedly to check her breasts as she had a bloody discharge coming out staining her gown and many lumps. We were told that when she is released she needs to go have a mammagram. WTF?? This is the healthcare today?? I believe the hospitals are just killing the elderly to save the medicaremedicaid funds for the immigrants and minorities who abuse the system.
DeborahAugust 9, 2011 at 1:01 am
My father had Alzheimers and was lucid and mobile when he went into the nursing home. At home, he was able to shave every morning and take care of himself. Our big problem was that he liked to wander. When he went in, he was taking Arocept. After going into the home, they changed his medication and put him on Seroquel. Within a month, he was completely demented, didn't know where he was, lost h[Show More]My father had Alzheimers and was lucid and mobile when he went into the nursing home. At home, he was able to shave every morning and take care of himself. Our big problem was that he liked to wander. When he went in, he was taking Arocept. After going into the home, they changed his medication and put him on Seroquel. Within a month, he was completely demented, didn't know where he was, lost his false teeth and his hearing aid and was in a diaper. Shortly afterward, he died.