How do we reach new antipsychotic goals?

In June, McKnight’s reported that CMS is pushing for further reductions in antipsychotic use for people living with dementia in nursing homes. The 19.4% nationwide reduction achieved by the end of last year is just short of the 20% target set by CMS in 2012. There is a push for a total reduction of 25% this year and 30% by the end of 2016.

These are laudable goals, but can they be achieved? There is reason for concern. While there is great variation among individual homes, a graphing of the quarterly numbers over the past three years shows a pronounced flattening of the curve over the past year. Both the national numbers and those of most individual states show that they are reaching a plateau.

In fact, nearly half of all states found their antipsychotic use to be level or slightly increased over the last two quarters of 2014, and only 8 states had an absolute reduction of 2% or more over the prior year. Clearly, nursing homes have found all of the “low-hanging fruit”—the people whose drugs could be easily stopped—but most are having trouble figuring out how to take it to the next level.

– McKnight’s

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