Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
March 18, 2015 01:00 AM

Antipsychotic use boosts mortality risk in dementia patients

Sabriya Rice
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    The number of deaths associated with using antipsychotic drugs in dementia patients may be higher than previous estimates. The mortality rate for use of one high-dose antipsychotic, for example, was found in a new study to be four times greater than previous studies had discovered.

    “Prescribing a medication that increases mortality risk seems contrary to the tenet “First, do no harm,” wrote authors from the University of Michigan and the VA Center for Clinical Management Research in the latest study published Wednesday in JAMA Psychiatry.

    All of the high- and low-dose antipsychotics evaluated were linked to increased death rates when compared to patients not given the drugs, but the risk increased along with the dose. The rates include a 3.8% increased mortality risk among patients prescribed haloperidol; 3.7% increased risk for risperidone; 2.7% for olanzapine; and 2% risk for quetiapine, according to the findings.

    Major concerns about antipsychotics have been raised in recent years due to continued overprescribing of the drugs for off-label purposes. Most are Food and Drug Administration-approved for patients with schizophrenia, but they have widely been used off-label to manage aggression, agitation and other behaviors in elderly dementia patients.

    Besides mortality, the team also evaluated the “number needed to harm,” or the number of patients who would need to receive treatment before one death would occur. They found that for every 26 patients treated with haloperidol, there was one additional death within six months that would not have been expected to occur had those patients not received the drug. For every 50 patients taking quetiapine, one unnecessary death might occur over six months.

    “At this point, I think providers are very aware of the risks of using these medications,” said Dr. Donovan Maust, an assistant professor of psychiatry at the University of Michigan and lead researcher of the new study. Persistent use, despite warnings, speaks to how distressing and potentially dangerous the behaviors can be, he said. “It also speaks to the fact that providers feel that they have few other tools to help address these behaviors.”

    Federal and other initiatives have focused intently on encouraging nursing homes to find alternative means of managing dementia patients, due to the riskiness of the drugs. Some facilities found they could achieve success by making adjustments to the nursing home environment, like eliminating loud noises that led to increased aggression or reducing the brightness of lights that prevented patients from sleeping well.

    Maust said reimbursement incentives also could help with rates. “But a nondrug behavioral intervention is precisely the type of 'cognitive' (nonprocedural) service that is difficult to deliver in traditional, fee-for-service care models,” he said.

    The retrospective analysis used 90,786 Veterans Health Administration records of patients 65 and older who received antipsychotics or an antidepressant between October 1998 and September 2009.

    Recent studies also have pointed to a need to expand focus beyond just nursing homes. Internists, family medicine physicians, psychiatrists and neurologists wrote more than 80% of the prescriptions for antipsychotics for older adults with dementia in 2012, according to a report released earlier this month. More than 90% of every medication group in the new JAMA Psychiatry study was not associated with a nursing home stay in the prior year, the study found.

    Follow Sabriya Rice on Twitter: @Sabriyarice

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    merger-arrows-money_i.png
    Option Care Health CEO stands by $3.6B Amedisys deal
    Why home is becoming the future for hospitals
    Why home is becoming the future for hospitals
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing