Thursday, July 26, 2012

Top brain specialist calls for ban on antipsychotic in elders

A senior neurologist at Beth Israel Deaconess Medical Center says many hospitals inappropriately use the antipsychotic Haldol "like water" in agitated elderly patients, putting them at risk for serious complications.
Dr. Louis Caplan, a neurology professor at Harvard Medical School, said a recent government report that found pervasive use of antipsychotic medications in elderly nursing home patents underscores the "overuse" problem with this class of drugs.
Caplan said Haldol is typically given to agitated patients to calm them quickly, but he said older patients, especially, can become over-sedated and stiff, putting them at risk for pulmonary and urinary infections, because they have trouble moving and couging.
"I would love to see Haldol banned from use in hospitals," Caplan said. "It has no role to play in hospitalized, agitated patients."
A report released this month by the Inspector General's Office of the federal Department of Health and Human Services found that 51 percent of Medicare claims for a newer class of antipsychotics, known as atypical, were prescribed inappropriately to nursing home patients.
The Inspector General reviewed medical records from 2007 and and found that 83 percent of Medicare claims for atypical antipsychotic drugs for elderly nursing home residents were associated with conditions not intended for that use. The report also found that 88 percent were associated with a condition that could produce serious side-effects, conditions for which federal regulators had specifically warned against such usage.
The use of such drugs is especially worrisome in nursing homes because a substantial number of residents suffer from dementia, a condition that puts them at greater risk of death when given antipsychotic medications.
The drugs were developed to treat people with severe mental illnesses such as schizophrenia, not dementia, which is the progressive loss of memory or other intellectual function than can result from aging or Alzheimer's disease.
Fderal regulators have issued nationwide alerts about troubling and sometimes fatal side effects when antipsychotics are taken by people with dementia, including increased confusion, sedation, and weight gain
Haldol is an earlier class of antipsychotic drugs, but Caplan said it's just as problematical.

Top brain specialist calls for ban on antipsychotic in elders

Sunday, July 22, 2012

High Fall Rates Among Short-Stay Nursing Home Patients

One in five short-stay nursing home patients sustains a fall after their admission, and certified nursing assistant (CNA) staffing is associated with decreased fall risk, according to a study led by USC researcher Natalie Leland. The study recently was published in the Journal of the American Geriatrics Society.
Though falls are unintentional, they hardly are insignificant: the Centers for Medicare & Medicaid Services reports fall rates as a quality indicator, and falls of nursing home residents have been associated with greater morbidity, mortality and health care costs.
Leland, who holds joint appointments at the USC Division of Occupational Science and Occupational Therapy and the USC Davis School of Gerontology, and colleagues from Brown University analyzed the 2006 Minimum Data Set (MDS) assessments of all first-time Medicare and Medicaid patients admitted to a nursing home

USC-Led Study Analyzes Fall Rates Among Short-Stay Nursing Home Patients | USC News