Study Shows Frequent Administration of Antipsychotics to VA Nursing Home Residents

A recent study adds to the growing body of research regarding overuse of antipsychotic medications in nursing home patients and the associated risks of severe medical complications and death, with a specific focus on residents of nursing homes run by the U.S. Department of Veterans Affairs (VA). The American Public Health Association’s Medical Care Section published the report in the November issue of its official journal, Medical Care. The VA is reportedly making a variety of efforts to reduce antipsychotic use among patients who would be better served by other treatments. This is particularly true of dementia patients in nursing homes.

The researchers, led by Walid Gellad, M.D., M.P.H., reviewed data from the VA’s 133 Community Living Centers around the country from the period January 2004 through June 2005. The data covered 3,692 veterans 65 years of age and older who were admitted to one or more of these facilities for at least ninety days. They found that 948 patients, just over one-quarter of the total number, received an antipsychotic medication, but that only 59.3% of them had an “evidence-based indication for use.” Patients who displayed aggressive behavior, who were receiving nine or more different medications, who were also receiving antidepressants or dementia medications, and/or who were living in an Alzheimer’s or dementia care unit were more likely to receive antipsychotic drugs. The researchers found that patients with dementia but no recorded history of psychosis were just as likely to receive antipsychotic drugs as those with a documented need for such drugs.

The use of antipsychotic medications in dementia patients is a growing cause for concern among doctors and public health specialists. For nursing home staff dealing with dementia patients who may be unruly or even violent, antipsychotic medications, such as Seroquel, Abilify, or Zyprexa, may seem to have a calming effect. Research has linked this use of antipsychotic drugs, however, to an increased risk of stroke, cardiac arrhythmia, pneumonia, and worsening of mental conditions in dementia patients, particularly those with no history of psychosis. A study conducted in the United Kingdom in 2009 found that about 180,000 dementia sufferers received antipsychotic medications, linking the drugs directly to about 1,800 deaths.

Several VA programs are reportedly underway to address antipsychotic use in VA nursing homes, according to the study’s authors. The VA, along with hospitals and other facilities around the country, have implemented Staff Training in Assisted Living Residences (STAR) programs, which provide training to nursing home staff on care for dementia patients. Studies have suggested that programs such as these can be effective, but dementia sufferers in nursing homes around the country still face problems and risks from staff who, for any number of reasons, continue to administer antipsychotics.

Nursing homes owe a duty of care to their residents to provide competent medical and other services. Facilities that breach this duty may be liable for the resulting injuries. At Lebowitz & Mzhen, we help people in Maryland obtain compensation for injuries caused by nursing home abuse or neglect. To schedule a free and confidential consultation, contact us today online or at (800) 654-1949.

More Blog Posts:

Medicare Formally Announces Partnership to Combat Use of Antipsychotic Medications as “Chemical Restraints” in Nursing Home Residents Suffering from Dementia, Maryland Nursing Home Lawyer Blog, June 14, 2012
Federal Government Launches Antipsychotic Medication Initiative to Protect Nursing Home Residents, Maryland Nursing Home Lawyer Blog, March 29, 2012
Pressure Mounts to Reduce Use of Antipsychotics in Dementia Patients, Maryland Nursing Home Lawyer Blog, September 27, 2011

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