CMS touts lower use of antipsychotic drugs in nursing homes

The CMS on Tuesday heralded a lower prevalence of antipsychotic drug use in the nation's nursing homes, which the agency attributes to a dementia-care program it launched last year.

According to the agency, data released on the Nursing Home Compare website in July showed that nursing homes are using antipsychotic drugs less and pursuing more patient-centered treatment for dementia and other behavioral healthcare.

In 2010, more than 17% of nursing home patients had daily doses of these drugs that exceeded recommended levels. To address that trend, the CMS created the National Partnership to Improve Dementia Care in 2012. The initiative seeks to lower the use of antipsychotic drug use by including enhanced training for nursing home providers and state surveyors; making antipsychotic drug use data transparent by posting it online at Nursing Home Compare; and focusing on alternative strategies to improve care for those with dementia. The partnership's goal is to reduce antipsychotic drug use by 15% by the end of this year.

Data show that the national prevalence of antipsychotic drug use in long-stay nursing home residents has decreased by 9.1% in the first quarter of 2013, compared with the last quarter of 2011. And at least 11 states—Alabama, Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee and Vermont—have already hit or exceeded the 15% target, according to the CMS.

“This important partnership to improve dementia care in nursing homes is yielding results,” Dr. Patrick Conway, the CMS' chief medical officer and director of the Center for Clinical Standards and Quality, said in a statement. “We will continue to work with clinicians, caregivers and communities to improve care and eliminate harm for people living with dementia.”

Sen. Chuck Grassley (R-Iowa), who called for an inspector general's audit of the use of antipsychotic drug use by dementia patients in nursing homes, called the new data from the CMS as “a step in the right direction.”

“However, CMS needs to continue making progress toward protecting nursing home residents from unnecessary antipsychotic prescriptions,” Grassley said in a statement. “The right kind and right level of medication are critical to nursing home residents' quality of care. The government needs to be sure nursing home residents are getting good care in keeping with federal standards and good stewardship of tax dollars.”

Meanwhile, the American Health Care Association—which represents the nation's skilled-nursing providers—released its own data on antipsychotic drug use Tuesday. The group joined the CMS' National Partnership to Improve Dementia Care last year and also announced a similar goal to reduce off-label use of antipsychotic medications by 15% through its AHCA Quality Initiative.

AHCA reports that the percentage rate of long-stay residents who receive these drugs is slightly lower—21.3%—than the national average of 21.7%. That reflects a 10.5% decrease among AHCA members from the fourth quarter of 2011, which is the baseline period for both the CMS partnership and the AHCA Quality Initiative.

The association reports that 42% of AHCA members—or 3,391 skilled nursing centers—have achieved a 15% reduction in antipsychotic use, which has resulted in 15,995 individuals in AHCA member centers no longer receiving these medications.

Follow Jessica Zigmond on Twitter: @MHjzigmond