AMDA Press Statement in Response to ProPublica Antipsychotics Prescribing Report

May 21, 2013
Perry Gwen Meyers,

Columbia, MD — In response to the ProPublica report, “Medicare Drug Program Fails to Monitor Prescribers, Putting Seniors and Disabled at Risk,” AMDA released the following statement: 

AMDA agrees that ongoing efforts to educate physicians and other clinicians about appropriate prescribing and management of antipsychotic medications are necessary. Through educational programs, articles in our publications, and a direct call to action to our members, we have encouraged post-acute and long-term care physicians to identify the underlying causes and factors contributing to behavioral symptoms and to use non-pharmacologic interventions whenever possible. AMDA’s educational initiatives stress a team approach to care that focuses on safety, appropriate goals and outcomes, and patient choices and preferences. Our outreach to members included a letter sent in June of 2012 asking AMDA’s medical director members to “join with AMDA and CMS in the nationwide effort to reduce the unnecessary use of antipsychotic agents by refocusing the interdisciplinary team on a better understanding of the root cause of dementia-related behaviors,” and provided the letter recipients with tools and advice on how to do so. The letter can be accessed here.

AMDA has long supported the thorough evaluation and treatment of patients with behavioral issues, and our goal is to help all interdisciplinary team members become comfortable and proficient in caring for residents with dementia. AMDA is committed to educating post-acute and long-term care providers and collaborating with state survey agencies to ensure appropriate and responsible use of medications, including antipsychotics.

AMDA believes that there are instances in which antipsychotics may be appropriate (such as for psychosis), but that there should be documented justification for initiating these medications, documentation of ongoing efforts to gradually reduce dosages or discontinue these medications, and documentation of discussions about medication risks and benefits with the patient or designated decision maker. Our educational programs, such as our “Navigating Mood and Behavior Challenges in Long Term Care: Strategies for Optimal Outcomes,” encourage the interdisciplinary team’s consistent and appropriate use of care processes to guide selection and use of antipsychotic medications. 

AMDA supports the robust and coordinated pharmacy review process in post-acute and long-term care and encourages physicians to work with pharmacists and other team members to make treatment decisions that are in the best interest of each individual resident.