Medicare and Medicaid say antipsychotics are still used too often in nursing home dementia units
When dementia patients get to a stage where they become very agitated, people start looking for an easy fix.
In an article in MedPageToday, Leonard Gelman, MD, CMD, president of the board of directors of the American Medical Directors Association was interviewed on dementia patients and the use of antipsychotics.
When dementia patients get to a stage where they become very agitated, “people are looking for an easy fix. So these medications are used,” even though in many cases they don’t help,” Gelman continued. On the other hand, “the things we know work the best are most difficult logistically, and that is, essentially, having someone be with the patient … all the time.”
“Many people think that most of the medications nursing home patients take have been prescribed by the nursing homes, but that’s not the case, said Gelman. “They get prescribed in the hospital [or by the patient’s primary care physician]. In essence, the nursing home doctors rarely prescribe these things, but we continue them for many different reasons, unfortunately. It’s a merry-go-round that keeps going ’round and ’round but it’s difficult to push the horse off the merry-go-round, because everyone has told the family and the patients they need [the medications].”
Reducing antipsychotics is part of a larger approach on nonpharmacologic treatment for these patients, according to Gelman. “In general, this is one of things we’ve been internally talking about, and also talking with CMS and others,” he said. “There are many instances where medications can be reduced, not just antipsychotics — certainly benzodiazepines, also blood pressure medications and cholesterol medications.”
The agency also released a fact sheet with state-by-state data on antipsychotic reductions. States varied in how much they reduced use of these medications over a 21-month period ending with the first quarter of 2014 — Hawaii reduced use in that state by 31.4%, while Nevada reduced antipsychotic use by 1.6%.
Even though this data is several years old, it gives you an idea of what states are dealing with and which ones met their reduction goal. Along with anti-psychotic medication monitoring, updated CMS regulations coming in 2018 increase the scrutiny of medication review. A simple, straightforward solution is needed – one that offers providers an effective tool that aligns prescribed medications to the unique needs of each resident.
Most nursing homes are being proactive – setting programs in place to be ahead of any future mandates or regulations. That’s where PGx Medical comes in. Our fully reimbursed diagnostic test can help guide healthcare professionals when dosing residents. Right drug, right dose, for the right person. Pharmacogenetics aligns current and future medications with each persons unique genetic profile – individualized treatment that can give them the therapy they need.
If you don’t have a medical plan of action to help reduce antipsychotics along with other medications, contact us and we’ll help you get started.
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
source: medpagetoday