Monitor on Psychology - September 2011 - (Page 11)

Antipsychotics overprescribed in nursing homes the report suggests that Medicare overseers Physicians are widely prescribing antipsychotics to reassess their nursing home certification processes people in nursing homes for off-label conditions such and develop methods besides medical review as dementia, and Medicare is largely picking up the to confirm that medications are prescribed for bill, even though Medicare guidelines don’t allow for appropriate conditions. off-label prescription reimbursements, according to Why such high rates an audit released in May of overprescription for by the U.S. Department of antipsychotics? HHS Health and Human Services Inspector General Daniel office of the Inspector Levinson argued in the General. report that pharmaceutical the findings underscore companies’ marketing the fact that antipsychotics tactics are often to are often used when blame for antipsychotics’ behavioral treatments overprescribing. would be more effective, victor Molinari, PhD, a psychologists say. geropsychologist at the the office reviewed University of South Florida Medicare claims of people in tampa, says that another age 65 and older living important issue is the in nursing homes in 2007 dearth of psychologists — the most recent data trained to provide at the time the study behavioral interventions to began — and found that people in nursing homes. 51 percent of all claims While he agrees that people contained errors, resulting in nursing homes are taking $116 million worth of too much antipsychotic antipsychotics such as medication, he believes Abilify, risperdal and nursing home physicians Zyprexa being charged to are often responding to a Medicare by people whose lack of options. conditions didn’t match the Antipsychotics are often used when behavioral Many nursing home drugs’ intended uses. treatments would be more effective, psychologists say. administrators are quite Among the audit’s findings savvy in their mental health knowledge and would are: prefer to offer their residents the option of behavioral • 14 percent of the 2.1 million elderly people living treatments, Molinari says, but when residents in nursing homes use Medicare to pay for at least need immediate calming, physicians will turn to one antipsychotic prescription. antipsychotic medication because it’s quick and • 83 percent of all Medicare claims for available. Additionally, he says, many nursing home antipsychotics are, based on medical reviews, staff aren’t educated enough about nonmedical prescribed for off-label conditions, specifically options, so they go straight for the antipsychotics. dementia. “It follows the saying, ‘If your only tool is a • 22 percent of the claims for antipsychotics do not hammer, everything is a nail,’” he says. “nursing comply with the Centers for Medicare and Medicaid homes are not just straitjacketing residents with Services’ guidelines outlining how drugs should be medications as a matter of course, but because there administered, including those guidelines stating that are a host of barriers to giving them optimal care.” nursing home residents should not receive excessive doses and doses over excessive periods of time. —M. PRiCE septeMber 2011 • Monitor on psychology 11

Table of Contents for the Digital Edition of Monitor on Psychology - September 2011

Monitor on Psychology - September 2011
President’s Column
From the CEO
Supreme Court hears psychologists on prison and video game cases
Antipsychotics are overprescribed in nursing homes
New MCAT likely to recognize the mind-body connection
A $2 million boost for military and families
In Brief
On Your Behalf
Judicial Notebook
Random Sample
Speaking of Education
An uncertain future for American workers
Advocating for psychotherapy
Seared in our memories
Helping kids cope in an uncertain world
APA and Nickelodeon team up
Muslims in America, post 9/11
Bin Laden’s death
‘They expect us to be there’
Answering the call of public policy
Candidates answer final questions
APA News
Division Spotlight
New leaders
Disaster relief training
Honoring teaching excellence

Monitor on Psychology - September 2011