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Medical News & Perspectives
September 18, 2013

Efforts Stall to Curb Nursing Home Antipsychotic Use

JAMA. 2013;310(11):1109-1110. doi:10.1001/jama.2013.276603

Federal efforts to reduce unnecessary off-label prescribing of antipsychotic drugs for nursing home patients have stalled because of budget cuts that scuttled an investigation of this problem and lackluster results from a voluntary effort to address such inappropriate use of these drugs.

The US Food and Drug Administration warned in 2005 that use of newer generation atypical antipsychotics among elderly patients with dementia to control behavioral problems increased their risk of death (http://1.usa.gov/13JCOt2). Despite this warning and more recent federal efforts to curb prescribing this class of drugs to vulnerable elderly patients, high rates of inappropriate prescribing continue. More than 1 in 5 nursing home residents were prescribed antipsychotic medications in the first quarter of 2013, despite not having a diagnosis that would warrant such prescribing, according to data from the Centers for Medicare & Medicaid Services (CMS).