Data show National Partnership to Improve Dementia Care achieves goals to reduce unnecessary antipsychotic medications in nursing homes
The Centers for Medicare & Medicaid Services (CMS) established the National Partnership to Improve Dementia Care in Nursing Homes in 2012. The partnership utilized a multidimensional approach which included public reporting, partnerships and state-based coalitions, research, training for providers and surveyors, and revised surveyor guidance to empower and build upon the efforts of organizations across the country. The Partnership seeks to optimize the quality of care and quality of life for residents in America’s nursing homes by improving care for all residents, especially those with dementia. While the initial focus of the partnership was on reducing the use of antipsychotic medications, the larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices.
Today, the National Partnership to Improve Dementia Care announced that it met its goal of reducing the national prevalence of antipsychotic use in long-stay nursing home residents by 30 percent by the end of 2016. It also announced a new goal of a 15 percent reduction by the end of 2019 for long-stay residents in those homes with currently limited reduction rates, using the prior baseline rate (fourth quarter of 2011). The data below show current trends related to the prevalence of antipsychotic use.
Current data trends
Between the end of 2011 and the end of quarter one of 2017, the national prevalence of antipsychotic use in long-stay nursing home residents was reduced by 34.1 percent, decreasing from 23.9 percent to 15.7 percent nationwide. All 50 states and every CMS region showed improvement. Some states showed much more improvement than others. The states that have reduced their rate by the most percentage include the District of Columbia (47.8 percent), Tennessee (43.5 percent), California (43 percent), and Arkansas (41.6 percent). (Data on all states is below in figure 3).
Nursing homes with low rates of antipsychotic medication use are encouraged to continue their efforts and maintain their success, while those with high rates of use are to work to decrease antipsychotic medication use by 15 percent for long-stay residents by the end of 2019. Data for homes with high rates of use has been collected and will be shared with State Dementia Care Coalitions for outreach purposes.
Figure 1: Quarterly Prevalence of Antipsychotic Use for Long-Stay Nursing Home Residents, 2011-Q2 to 2017-Q1
Figure 2: Quarterly Prevalence of Antipsychotic Use for Long-Stay Residents, CMS Regions* 2011-Q2 to 2017-Q1
*Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York, Puerto Rico, Virgin Islands; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Kansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada, Pacific Territories; Region 10: Alaska, Idaho, Oregon Washington
Figure 3: Quarterly Prevalence of Antipsychotic Use for Long-Stay Residents, States 2011-Q4 to 2017-Q1