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Are Elderly Patients Being Overprescribed Anti-Psychotic Drugs?

Elderly patients with dementia are too often prescribed anti-psychotic drugs to calm their disruptive behavior, a panel of experts told lawmakers at a hearing before the Senate Committee on Aging. In order to protect these elders from abuse, more care should be taken to determine why dementia patients may be acting up and treat those underlying causes, they said.

“As the baby boomer generation ages, it is imperative to address the overuse and misuse of antipsychotic drugs among nursing home patients,” said Daniel Levinson, Health and Human Services Inspector General.

Below are a few alarming statistics highlighted during the hearing:

  • One government audit showed 14 percent of nursing home residents had Medicare claims for antipsychotic drugs.
  • Nursing facilities’ self-reported data indicate that in the third quarter of 2010, 26.2 percent of residents had received antipsychotic drugs in the previous seven days.
  • Facilities reported they gave antipsychotic drugs to many residents who did not have a psychosis, including 40 percent of patients at high risk because of behavior issues.

Why Are Facilities Overprescribing Anti-Psychotic Drugs?

Experts cite several reason for the misuse of anti-psychotic drugs. Serious understaffing in nursing facilities, high turnover of staff, and aggressive off-label marketing of anti-psychotic drugs may all play a role.

According to Tom Hlavacek, executive director at Alzheimer’s Association’s southeastern Wisconsin chapter, elderly people with dementia are sometimes also prescribed these potent drugs for agitated behaviors that have other underlying causes, such as urinary tract infections, tooth decay, arthritic pain, or simply moving a patient from one place to another

“Our experience indicates that these care transitions can exacerbate behaviors and often lead to escalating drug treatments,” he told lawmakers.

What Can Be Done to Address Overprescribing of Anti-Psychotic Drugs?

Experts said the problem could be addressed by creating stronger penalties for inappropriate prescribing, and a renewed focus on trying non-pharmacological solutions to a problem first.

“Most doctors treat unwelcome behavior in all settings as a disease that requires medication. These drugs are used as chemical restraints,” said Jonathan Evans, a doctor who specializes in caring for frail elders.

“Behavior is not a disease. Behavior is communication. And in people who have lost the ability to communicate with words, the only way to communicate is through behavior,” he added.

“Good care demands we figure out what they are telling us and help them.”

Source: New York Daily News