Category: Federal Forum Posters
Purpose: Antipsychotics have been associated with increased mortality when used off-label for dementia-related behaviors. The Centers for Medicare and Medicaid Services guidance document emphasizes the importance of appropriate antipsychotic dosing and duration to improve quality of care in nursing homes. Since 1991, gradual dose reductions have been mandatory for dementia-related behaviors. More recently, interpretive guidelines require gradual dose reductions for all antipsychotics, regardless of indication. The purpose of this medication use evaluation is to assess the incidence of antipsychotic dose reduction attempts, evaluate behavioral outcomes after dose reductions, and to identify factors that may contribute to the likelihood of successful reductions.
Methods: A retrospective chart review will be conducted including residents in the community living center for greater than one year and on an oral or injectable antipsychotic between January 1st, 2013 and September 1st, 2018. Palliative care patients will be excluded. The following data will be collected: patient demographics; antipsychotic agent, dose, and duration of use; dose reduction attempts; documentation for contraindications to dose reductions; and frequency of antipsychotic dose changes.
Amber Bradley– Pharmacy Resident, James J Peters VA Medical Center, Jersey City, NJ