Assessing approaches and barriers to reduce antipsychotic drug use in Florida nursing homes

Abstract

Objectives: Antipsychotic medications have been federally regulated since 1987, yet research suggests they continue to be used inappropriately to alleviate behavioral symptoms associated with dementia. In 2012, the Centers of Medicare and Medicaid launched a new initiative to reduce antipsychotic medication in nursing homes by 15% nationally. The aim of this study was to examine qualitative data to explore strategies that have been implemented, to assess which strategies are evidence-based, and to make recommendations to improve upon practices to reduce antipsychotic medication use.

Method: A convenience sample of 276 nursing home professional staff members were surveyed about these topics using open-ended questions.

Results: Theme-based content analysis yielded three main themes. The themes related to changes in practice included the following: (1) increased review of resident behavior and antipsychotic medication regimens; (2) reduction in antipsychotic medications or dosage; and (3) increased use of nonpharmacological interventions. The main themes relevant to needed assistance included the following: (1) education; (2) clinical support; and (3) increased financial resources and reimbursement.

Discussion: Overall findings indicate that the majority of facilities are actively responding to the initiative, but challenges remain in education, finding mental health support, and in reimbursement.

Keywords:

• antipsychotic medications
• nursing homes
• qualitative methods
• survey

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Erratum

Acknowledgement

The authors would like to acknowledge and thank LeadingAge for their support in this project. The authors would also like to specifically thank Janegale Boyd and staff for their assistance in obtaining registration data for the 2013 Joint Trainings.