Kathryn Price’s blog had an article on the use of anti-psychotics in nursing homes despite the FDA’s black box warnings. Human Rights Watch, a nonprofit, nongovernmental human rights organization, released a report this year that shows nursing homes are overprescribing antipsychotic drugs to manage the behavior of dementia patients even though anti-psychotic drugs are not FDA approved as treatment for dementia.
The FDA mandates that a black box warning appear on anti-psychotic medications, which cautions that they may lead to an increased risk of death for dementia patients. Additionally, research exists supporting the idea that anti-psychotics can be harmful when used for behavioral reasons alone on dementia patients, including an increased risk of death, falls, and reduced cognitive functioning.
The federal government does have regulations aimed at preventing this. One such regulation appears in a 2016 revision to the Centers for Medicare & Medicaid Services’ (CMS) regulations for Medicare and Medicaid certified nursing facilities. The regulations state that “Residents who have not used psychotropic drugs are not given these drugs unless the medication is necessary to treat a specific condition as diagnosed and documented in the clinical record.”
According to federal regulations, patients and/or their guardians have a right to understand the purpose of their prescribed medical treatment prior to administering, which is vital to preventing the prescription of unnecessary anti-psychotic drugs.
Despite these regulations, the report maintains that anti-psychotic drugs are still used to treat behavioral concerns in dementia patients due to a lack of enforcement. A 2014 NPR report indicates the penalties that exist for unnecessary prescriptions are rarely used and of the infractions reported only 2 percent were severe enough to warrant a fine.
CMS launched a program in 2012 to combat the improper usage of antipsychotic drugs in nursing homes and by late 2016, CMS announced that it met its goal of reducing the national prevalence of antipsychotic use in long-stay nursing home residents by 30 percent.