Nursing home antipsychotic use under fire

Massachusetts joins the cadre of states spending funds on antipsychotics for nursing home patients who probably shouldn't be given the drugs at all, the Boston Globe reports. According to data collected by the Centers for Medicare and Medicaid Services, 28 percent of the state's nursing home residents got antipsychotics last year. Of that group, 22 percent--2,483 patients--did not have a medical condition indicated for that treatment.

The state's nursing home trade group, the Massachusetts Senior Care Association, said that too many are using antipsychotics in their elderly residents. "We recognize the number is too high," SVP Scott Plumb told the Globe, "and we are working to try to bring it down."

Nursing homes across the country have come under fire for using powerful antipsychotic drugs such as Eli Lilly's Zyprexa, AstraZeneca's Seroquel, Johnson & Johnson's Rispderal, and similar meds. And you'll recall that FDA has issued warnings against using these drugs for patients with dementia because of serious safety risks. The federal government recently sued J&J for alleged involvement in a kickback scheme designed to boost use of Risperdal in dementia patients with behavioral problems.

Apparently, the difference lies in training: Well-trained nursing home staff can used behavior management to help quell dementia patients' agitation, and thus reduce the need for drugs. In homes where staff is untrained, up to 80 percent of residents are on antipsychotic meds, whereas in homes with well-trained staff, drug use is about 2 percent to 3 percent, an Alzheimer's Association representative told the Globe.

- see the story in the Globe

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