Reducing Inappropriate Psychotropics Use in Patients With Dementia

Study authors noted areas of improvement for potentially reducing inappropriate psychotropic medication use among patients with dementia in nursing homes (NHs).

While the use of antipsychotics decreased in 2012 with help from the Centers for Medicare and Medicaid (CMS) National Partnership to Improve Dementia Care in NHs, inappropriate psychotropics use to control behavioral symptoms associated with dementia still persists.

Researchers utilized quantitative analysis to assess the frequency of involved psychotropic medications, the scope/severity of F-758 deficiency citations, and reasons for the citations from January 2018 through March 2018 at 3526 NHs.

Among the 642 NHs flagged, the most involved drug category related to F-758 tag citations was reported as antipsychotics.

“The 3 most common reasons for F-758 citations included failure to identify and/or monitor behavioral symptoms (178 NHs), attempt gradual drug reduction (131 NHs), and maintain 14-day limitations on PRN psychotropic orders (121 NHs),” wrote researchers.

Facilities with antipsychotics-related F-758 tags had higher rates of failure to identify/monitor behavioral symptoms (P < .001), provide adequate indications for psychotropics use (P < .001), and attempt gradual drug reduction (P < .001) when compared with NHs that had no involvement of antipsychotic drugs.

A higher prevalence of failure to maintain 14-day limitation on PRN orders (P < .001) and provide nonpharmacologic interventions (P < .001) was reported in NHs with F-758 tags related to inappropriate antianxiety medication use.

“Supporting quality of dementia care workforce and improving cooperation within health care staff and professionals are recommended to ensure proper nonpharmacologic and pharmacologic interventions,” concluded study authors.

Reference:
Yoon JM, Trinkoff AM, Galik E, et al. Deficiency citations on inappropriate psychotropics use related to care for behavioral symptoms of dementia. J Am Med Dir Assoc. Published online May 11, 2022. doi:10.1016/j.jamda.2022.04.006