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 'Culture and Nature' Of Care Must Change To Sustain Antipsychotic Cutbacks Momentum

Providers have taken several different approaches to cutting back on the off-label use of antipsychotic drugs in long term care, but permanent success will depend on changes in both “the culture and nature of care settings,” British researchers are arguing in a new study.
Poring over data from global studies on efforts to curb antipsychotic abuse that span three decades, researchers say that any number of intervention styles—from educational programs to forming multidisciplinary teams in care centers—showed at least short-term success in helping to liberate residents from antipsychotics.
But there hasn’t been a lot of follow up, and some are worried about the staying power of such efforts, corresponding author Jo Thompson Coon of the University of Exeter Medical School writes in the latest issue of the Journal of the American Medical Directors Association.
“Further qualitative work to explore the barriers and facilitators to the appropriate prescription of antipsychotic medications will support efforts to achieve sustained change in the varying specific contexts of individual care and nursing homes,” Coon says. “For prescribing levels to be reduced in the long term, the culture and nature of care settings and the availability and feasibility of nondrug alternatives need to be addressed.”
Earlier this month, federal regulators announced that America’s care centers had met their goal of slashing unnecessary antipsychotics by 15 percent and set even higher goals for the years ahead. Many advocates, though, have made clear that they believe that antipsychotics were merely one troublesome alley in a whole map whose treasure spot reads, “person-centered care.”

Bill Myers is Provider’s senior editor. Email him at Follow him on Twitter, @ProviderMyers.
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