Federal investigators say they have found evidence of widespread overuse of psychiatric drugs by older Americans with Alzheimer's disease, and are recommending that Medicare officials take immediate action to reduce unnecessary prescriptions.
The findings will be released Monday by the Government Accountability Office, an arm of Congress, and the Obama administration has already been working with nursing homes to reduce the misuse of antipsychotic medications like Abilify, Risperdal, Zyprexa and Clozapine. But in the study, investigators said officials also needed to focus on overuse of such drugs by people with dementia who live at home or in assisted living facilities.
The Department of Health and Human Services has taken little action to reduce the use of antipsychotic drugs by older adults living outside nursing homes, the report said. Doctors sometimes prescribe antipsychotic drugs to calm patients with dementia who display disruptive behavior like hitting, yelling or screaming, the report said. Researchers said this was often the case in nursing homes that had inadequate numbers of employees.
Dementia is most commonly associated with a decline in memory, but doctors say it can also cause changes in mood or personality and at times, agitation or aggression. Experts have raised concern about the use of antipsychotic drugs to address behavioral symptoms of Alzheimer's and other forms of dementia. The Food and Drug Administration says that antipsychotic drugs are often associated with an increased risk of death when used to treat older adults with dementia who also have psychosis.
Senator Thomas R. Carper of Delaware, the senior Democrat on the Homeland Security and Governmental Affairs Committee, said the report showed that "many seniors with dementia are getting risky mind-altering medications," funded in many cases by taxpayers and the Medicare program.
Senator Susan Collins, Republican of Maine and chairwoman of the Senate Special Committee on Aging, who with Mr. Carper requested the study, said, "The report raises many red flags concerning the potential misuse and excessive use of antipsychotic drugs for patients with Alzheimer's and Other dementias. "
Toby S. Edelman, who represents patients as a lawyer at the Center for Medicare Advocacy, said, "We could save money and provide better care if nursing homes reduced the inappropriate use of antipsychotic drugs."
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