A newly released GAO report, “Antipsychotic Drug Use: HHS Has Initiatives to Reduce Use among Older Adults in Nursing Homes, but Should Expand Efforts to Other Settings,” reviewed the prevalence of psychotropic drug prescriptions in older adults with dementia who were nursing home residents as well as those who live in settings with a lower level of required care. The report found that:
- Approximately 33% of older adults with a dementia diagnosis who were nursing home residents were prescribed antipsychotic drugs in 2012
- Approximately 14% of older adults with a dementia diagnosis who resided in other care settings were prescribed antipsychotic drugs in 2012
- Patient-specific factors including agitation and delusions are contributing factors in antipsychotics being prescribed
- Experts and research show that the settings that an individual is placed in contributes to the decision to prescribe antipsychotics including:
- Facility culture of prescribing
- Level of staff training and education
- Number of staff at the nursing home
The GAO recommended that HHS strengthen its approach to reviewing how antipsychotics are being prescribed in non-LTC settings, including assisted living and private residences. The GAO notes that CMS launched the National Partnership to Improve Dementia Care in Nursing Homes and has seen success with this program and should continue education and initiatives for more care settings. Nursing Home Compare 3.0 now includes in its score percent calculations of both short-stay and long-stay residents who are given antipsychotics.
Read the January 2015 GAO Report here.