Blumenthal, advocates for elderly target ‘chemical restraint’ abuse at care facilities

Calling it a form of chemical restraint, Sen. Richard Blumenthal and advocates for the elderly Tuesday blasted the practice of prescribing antipsychotic drugs for dementia patients in nursing homes and other long-term care facilities.

“It is a form of elder abuse. It’s chemical restraint — no less pernicious and insidious than physical restraint of patients — and it should be stopped,” Blumenthal said.

During a press conference at the Capitol, Blumenthal announced that he has introduced a bill to crack down on the overprescription of these off-label drugs. At the same time, health care advocates and advocates for the elderly announced that they have formed a statewide coalition that aims to reduce this type of off-label antipsychotic drug use in Connecticut by 15 percent.

Both Blumenthal and the coalition are trying to combat the practice of giving agitated or confused dementia patients antipsychotic drugs, such as Risperidone, Quetiapine and Olanzapine, to calm them down.

This type of “off-label” use has not been approved by the FDA. These drugs can cause excessive sedation and unresponsiveness and can increase the risk of stroke and death in fragile, elderly patients, Blumenthal said.

Connecticut nursing homes use off-label antipsychotic drugs 24 percent to 65 percent of the time, while the national average is 23.9 percent, said Nancy B. Shaffer, state ombudsman for the state’s office of long-term care.

“We have some work to do,” she said.

The practice is also costly for taxpayers. An Inspector General report last year found that 83 percent of Medicare claims for antipsychotic drugs for nursing home patients were for off-label conditions.

Blumenthal introduced the bipartisan bill along with Sens. Herb Kohl, D-Wis., and Chuck Grassley, R-Iowa, last month in an effort to crack down on the abuse and misuse of the drugs.

The bill requires consent from family members if these drugs are going to be used on patients. It also would create education programs to train prescribers and nursing home staff. In addition, nursing homes would have to produce a monthly report on the use of antipsychotic drugs at their facility.

New group

In addition to the bill, organizers of a new Connecticut coalition called the Partnership to Improve Dementia Care in Nursing Homes said they are hoping to spread the word about the practice. Their goal is to reduce the use of these drugs in state nursing homes by 15 percent.

The coalition is sponsored by QUALIDIGM, the Medicare quality improvement organization in Connecticut. The diverse group, which includes nursing home groups, public health employees and pharmacist groups, will try to spread the word about the problem.

Rather than using these drugs as a first line of defense, nursing homes and long-term care facilities could try other techniques to calm agitated patients, such as music or touch therapy or getting to know the patient’s routines to make sure they are not disrupted, elderly advocates said.