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 CMS Joins Forces With Providers To Limit Use Of Antipsychotics

The Centers for Medicare & Medicaid Services (CMS) today urged its long term care partners to reduce the use of antipsychotic drugs by 15 percent by the year’s end.

Anywhere from one in five to two in five nursing facility patients take daily antipsychotic doses that are higher than recommended levels, CMS statistics show. It’s an obstacle to treating patients with dementia, the agency said.

“We want our loved ones with dementia to receive the best care and the highest quality of life possible,” Acting CMS Administrator Marilyn Tavenner said Wednesday. “We are partnering with nursing homes, advocates, and others to improve the quality of care these individuals receive in nursing homes.”

CMS will work with industry to roll out what it’s calling “Hand in Hand,” a new training regime that “emphasizes person-centered care, prevention of abuse, and high-quality care for residents,” Tavenner said. The agency will also post data on nursing homes’ use of antipsychotic drugs beginning in July and will emphasize alternatives to using antipsychotic drugs with patients, the agency said Wednesday.

The initiative won a hearty endorsement from David Gifford, MD, senior vice president of quality and regulatory affairs for the American Health Care Association (AHCA).

“We believe these antipsychotic medications are overprescribed,” he said Wednesday during a conference call with reporters hosted by CMS. AHCA and Leading Age committed to the 15 percent reduction in February. By year’s end,18,000 residents could be freed from unnecessary drug regimes, Gifford said.

Much remains to be done, however, Gifford added. That’s in part because many patients and their families still think that antipsychotic drugs are the best remedy for their loved one’s torments. “The data show otherwise,” Gifford said.

“While many clinicians and consumers believe these medications are effective, we know from medical literature that antipsychotics have limited effectiveness and actually increase the health risks for individuals,” Gifford said Wednesday. “We also know there are many facilities that have very low use of antipsychotics and are focusing on non-pharmacological approaches that have been shown to improve care and quality of life for residents. It’s time to put everything we know to good use.”

CMS officials acknowledged Wednesday that the 15 percent reduction goal is “ambitious.”

But Gifford said he was confident that everyone involved was pulling on the same end of the rope.
“Providers are up to the challenge,” he said.

Consumer advocate Claire Curry of the Legal Aid Justice Center also joined Wednesday’s conference call.

She hailed CMS for bringing national attention to what she called the “national disgrace” of “chemical restraint” and thanked industry for being willing to “be an agent of change.”

revised May 31, 2012
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