Reducing the use of antipsychotic drugs in Texas nursing homes

Despite years of underfunding, Texas is a leader in the rate of reduction of antipsychotic medication use in nursing homes. State data show a drop from 28.8 percent of residents in Texas nursing homes being administered antipsychotic medications in 2011 to just 16 percent through the third quarter 2017.

That’s real progress — and the result of hard work and collaboration. Reducing the use of antipsychotic drugs in nursing homes is a national issue and a top priority in Texas.

Since 2012, Texas has seen 18 consecutive quarters of reduction in the use of antipsychotics for long stay residents.

For the well-being of these most fragile Texans, use of these drugs should be greatly reduced.

Accomplishing this goal requires close collaboration between providers, regulators, advocates and clinicians.

The reduction in the use of antipsychotics is a result of statewide and local training efforts, improved care coordination, and grant programs coordinated by the Texas Health and Human Services Commission, specifically targeting antipsychotic medication reduction and improved care for residents with dementia. The progress seen in Texas is the work of countless frontline caregivers actively working with physicians and with families who struggle to care for their loved ones with dementia. With gradual dose reduction, providers individualize care plans and interventions to manage symptoms the antipsychotic medication was prescribed to address.

Changing attitudes and perceptions is also required. A key effort that will be part of any sustainable success is the education of community caregivers and families providing care prior to their admission to the nursing facility. This is important because research indicates that many residents who are on antipsychotics were prescribed the medication prior to being admitted to the facility. Antipsychotics can often be prescribed by a family physician intending to minimize the very behaviors that can result in a family bringing a loved one to a nursing home to begin with.

Families and those who care for the vulnerable citizens in nursing facilities are best able to address the overuse of antipsychotic medication.