Just two-and-one-half weeks after we published a blog post entitled Over-Prescribing for Elderly Labeled a "Disease", the Boston Globe publishes an article called Mass. aims to cut drug overuse for dementia. Thank goodness, this has come onto the Commonwealth's radar! The Globe article begins:
State regulators and the Massachusetts nursing home industry are launching a campaign today to reduce the inappropriate use of antipsychotic medications for residents with dementia — a practice that endangers lives and is more common here than in most other states.
I believe it's important to keep this thinking going beyond those in nursing homes. My prior post about overmedication was about community-based elders said in part:
Archives of Internal Medicine (see the study abstract here) showed that it was possible to safely and significantly reduce the use of medications in elderly patients living in the community (as opposed to in care facilities). In fact, almost all patients in the study had nearly 60% of their medications safely discontinued, with very, very few needing to have these drugs re-prescribed. As a result, 88% of patients reported improved health! "Polypharmacy itself should be conceptually perceived as 'a disease,' with potentially more serious complications than those of the diseases these different drugs have been prescribed for," the authors write.
I think the state's approach on this is right on: better education for carepartners. Though I would recommend that physicians -- not only nurses -- receive more updated training.
“There is a knowledge gap between the front-line workers — the nurses — and the black-box warnings on these medications,’’ said Laurie Herndon, a geriatric nurse practitioner who is leading the initiative for Massachusetts Senior Care, the trade group representing the state’s 430 nursing homes. A black-box warning is the most serious type of caution used in prescription drug labeling. "We wanted to avoid talking at them, and instead provide educational material they can use,’’ Herndon said.
One of the most wonderful -- and challenging -- aspects of working with an aging population is that best practices and the most up-to-date wisdom is quickly changing... and for the better. The challenge comes when very busy health care professionals are unable to keep abreast of ever-expanding changes -- a task difficult for even specialists in this field.
So that means it's vital that families advocate for their loved ones around medications -- and here you are, becoming better educated about the issues, right now. Bravo!
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