State Among Top Users Of Antipsychotic

Drugs In Nursing Homes

HARTFORD (AP) — Nursing homes in Connecticut have dispensed antipsychotic drugs to residents who do not have psychotic disorders at one of the highest rates in the country in the past two years, according to federal data.

Since 2005, Connecticut has ranked in the top four states in dispensing antipsychotic drugs to nursing home residents with no psychotic or related conditions, according to the Centers for Medicare and Medicaid Services.

The federal agency’s most recent quarterly report through September 2007 says the rate was higher only in Louisiana. In Connecticut, more than 26 percent of residents who lacked an appropriate psychiatric diagnosis were prescribed antipsychotics.

Nationally, the prevalence rate is 19.8 percent, with several states, such as Florida, New Jersey and Pennsylvania, below the average.

Charlene Harrington, a professor of sociology and nursing at the University of California-San Francisco, said a high prevalence of antipsychotic use in a nursing home could be due to inadequate staffing.

“You have to have the time to spend with people,” she said.

Alternatives to drugs for residents with dementia include recreational activities, exercise and one-on-one attention. All require staff.

The Connecticut General Assembly is considering proposals that would update the state’s minimum staffing standards, which are more than 25 years old. Nursing homes in Connecticut provide an average of about 3.7 hours of care per resident a day, with Connecticut law requiring 1.9 hours daily.

A study commissioned by the federal government recommends 4.1 hours of care for each resident.

The Nursing Home Reform Act of 1987 requires residents to be free of “chemical restraints” imposed for discipline or convenience. Federal guidelines allow nursing homes to administer antipsychotic drugs to residents with dementia-related behavioral symptoms, but residents must meet specific clinical criteria, doses must be reduced gradually and be accompanied by behavioral interventions to wean them off the medications.

State public health officials, supported by federal data, say the Health Department has aggressively cited homes for medicating residents unnecessarily.