A coalition of consumers, advocacy organizations, providers, and professional associations, is calling to reduce the use of antipsychotic medications in nursing homes by 25% by the end of 2015. Furthermore, the coalition, which includes the Centers for Medicare and Medicaid Services (CMS), LeadingAge, and Advancing Excellence in America’s Nursing Homes, would like to reduce use of these drugs by 30% by the end of 2016.
From the end of 2011 to the end of 2013, the use of antipsychotic drugs in long-stay nursing homes declined 15.1%. Since then, the usage rate has dropped even more with Hawaii showing the most improvement with a 31.4% reduction.
The coalition is hoping to enhance the use of non-pharmacologics. According to CMS, as the use of antipsychotics declines, the entity will monitor the situation to ensure nursing homes are not simply replacing the drugs with others.
However, despite the good intentions of the coalition, some have written to that they cannot endorse the goals. According to representatives from California Advocates for Nursing Home Reform, the Center for Medicare Advocacy, National Consumer Voice for Quality Long-Term Care and the Long Term Care Community Coalition, the proposed goals do not do enough to protect nursing home residents.
Furthermore, these representatives do not believe the goals set will meaningfully improve the current drugging practices of nursing homes. CMS Chief Medical Officer Patrick Conway, MD, said in a statement that CMS knows that many of the diagnoses of nursing home residents do not merit antipsychotics, but the drugs are used anyway.
“In partnership with key stakeholders, we have set ambitious goals to reduce use of antipsychotics because there are — for many people with dementia — behavioral and other approaches to provide this care more effectively and safely,” he said.