Cutting the Use of Antipsychotics in Nursing Homes

Use of antipsychotic drugs in nursing home can be cut significantly by training staff to recognize certain behavior by elderly patients as a sign of unmet needs.

Researchers in Massachusetts examined how a communication training program known as “Oasis” designed for nursing home staff impacted off-label antipsychotic use. Off-label prescribing of antipsychotics for nursing home patients with dementia is common, even though the drugs are not that effective at controlling behavioral symptoms and they come with an increased risk of stroke and death.

The study compared off-label prescribing use in 93 nursing homes enrolled in Oasis to 831 not involved in the program. In the Oasis facilities, antipsychotic prescriptions were reduced to 27% from 34% after just 9 months, the researchers reported in JAMA Internal Medicine. At the other nursing homes, there was only a 4% drop over the same period.

“The Oasis program asks nursing staff to create care plans that include what residents can do, shifting away from the model that focuses on what they can’t do,” lead study author Jennifer Tjia, MD, an associate professor of quantitative health sciences at the University of Massachusetts School of Medicine said in a statement. “This is a fundamental shift in how to think about caring for persons with dementia and we showed that it is effective.”

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