Government Audit Warns About Use of Antipsychotics in Nursing Home Patients

The CBS Evening News (5/9; Couric) reported that “a troubling new report from the government finds that all too often nursing homes are giving antipsychotic drugs to patients who should not be getting them.”

The New York Times (5/10) reports, “Nearly one in seven elderly nursing home residents, nearly all of them with dementia, are given powerful atypical antipsychotic drugs even though the medicines increase the risks of death and are not approved for such treatments, a government audit found.” What’s more, “more than half of the antipsychotics paid for by the federal Medicare program in the first half of 2007 were ‘erroneous,’ the audit found, costing the program $116 million for those six months.” In announcing the results of the audit, Daniel R. Levinson, inspector general of the Department of Health and Human Services, wrote, “Government, taxpayers, nursing home residents as well as their families and caregivers should be outraged and seek solutions.”

This is a disturbing report and it raises a few questions for me. Is dementia such a difficult problem that we are willing to try anything to treat it even if it is an unapproved treatment?

If pharmacists review patient charts in nursing homes every month, does this report suggest that this medication review is not very effective?

Perhaps the treatment of dementia is so very difficult to manage that it poses a dilemma for the health care professionals treating it. Does this report suggest that it is much easier for an auditor to make assessment after the fact than for a clinician to make assessment while treatment is taking place?