If an older adult experiences hallucinations and delusions, they may be diagnosed with schizophrenia and put on antipsychotic medication. But how often is this diagnosis accurate?
AP News announced on Jan. 18 that the Centers for Medicare and Medicaid Services (CMS) will launch an investigation this month exploring the potential misdiagnosis of schizophrenia in nursing homes and the overuse of antipsychotic drugs as a result.
“People in nursing homes deserve safe, high-quality care, and we are redoubling our oversight efforts to make sure that facilities are not prescribing unnecessary medications,” CMS Administrator Chiquita Brooks-LaSure said in a statement.
The investigation will look into select nursing homes to find out if patients are being properly diagnosed with schizophrenia, which is typically treated with antipsychotic medications. According to the National Institutes of Health, there can be safety concerns associated with treating other types of cognitive conditions – such as dementia – with antipsychotics.
Previous data from the Department of Health and Human Services found that 270,000 older adults in nursing homes living with dementia were put on antipsychotic drugs, regardless of the fact that these drugs are primarily recommended to treat schizophrenia.
Investigations from 2012 regarding the overuse of these medications has prompted a recent decrease in their use, but the government will now track how often schizophrenia is diagnosed in some nursing homes to ensure the only patients on antipsychotic drugs are the ones who need to be.
Although the World Health Organization reported that schizophrenia only affects approximately one in 300 people, a recent report from the HHS Office of the Inspector General found that from 2011 to 2019, 80% of Medicare’s long-stay nursing home residents were put on antipsychotic medication.
…from 2011 to 2019, 80% of Medicare’s long-stay nursing home residents were put on antipsychotic medication.
“There was a 194% increase in the number of residents reported in the [data set] as having schizophrenia, but who lacked a corresponding schizophrenia diagnosis in their Medicare claims,” HHS researchers stated.
These statistics raised concern about whether or not schizophrenia is being overdiagnosed to allow nursing home care professionals to administer antipsychotic medications more easily.
AP News reports that according to CMS, “Evidence has mounted over decades that some facilities wrongly diagnose residents with schizophrenia or administer antipsychotic drugs to sedate them, despite dangerous side effects that could include death.”
“No nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic,” Health and Human Services Secretary Xavier Becerra said in a statement. “The steps we are taking today will help prevent these errors and give families peace of mind.”