Anti-psychotics used on elderly can harm

Anti-psychotic medications persist at high levels in US nursing homes despite evidence they have few benefits and can be harmful, researchers say. Becky A. Briesacher of the University of Massachusetts Medical School in Worcester and colleagues assessed the level of anti-psychotic use in US nursing homes from September 2009 through August 2010. They used prescription dispensing data of a large, long-term care pharmacy that serves half of all US nursing homes residents. The data included state location, patients' sex, age, enrollment dates and national drug codes for all drugs dispensed regardless of payer -- e.g., Medicare Part D, private insurance or out of pocket. "The prescribing of anti-psychotic medications persists at high levels in US nursing homes despite extensive data demonstrating marginal clinical benefits and serious adverse effects, including death," Briesacher said in a statement. "However, imprecise and outdated data have limited the understanding of the current state of anti-psychotic medication prescribing in nursing homes." The study, published in the Journal of the American Medical Association, found the overall sample of 1.4 million nursing home residents, 22 percent received 1 or more prescriptions of anti-psychotics. The authors noted their "finding that 22 percent of nursing home residents received anti-psychotics in 2009-10 is within the lower range of rates that were documented 25 years earlier before the passage of the Omnibus Budget Reconciliation Act of 1987, which instituted regulations on the appropriate use of anti-psychotics in nursing homes, the study said. Briesacher said the length of time of the medication -- median duration of 30 to 77 days -- raises "concerns about the care of frail elders residing in nursing homes."