Inappropriate drug use found at VA


by  Kris B. Mamula – Reporter- Pittsburgh Business Times


More than one in four older veterans in nursing homes were taking antipsychotic medications, with more than 40 percent of those veterans having no documented related diagnosis, according to new research by the University of Pittsburgh and VA Pittsburgh Medical Center.

The study was the first to address this issue in VA Community Living Centers and the rates mirrored those in non-VA nursing homes. In July, the Pittsburgh Business Times found that the use of antipsychotic medications in nursing home patients who do not have a related diagnosis was higher in southwestern Pennsylvania than the statewide and national medians — 18.9 percent locally compared to 15.65 percent statewide and 16.7 percent nationally.

“Our study adds to the growing evidence base that antipsychotics have been overused in nursing homes and the VA is not immune to the program,” lead author Dr. Walid Gellad said in a prepared statement. “Behavioral symptoms in dementia patients are difficult to treat and in most cases, nursing home staff are doing what they can to keep patients comfortable and safe. We have to find better ways to do this, though.”

Antipsychotics have limited value in alleviating behavioral problems for people with dementia and several studies associate their use with an increase risk of death.

Gellad and his colleagues collected data on all veterans age 65 and older who were admitted for 90 or more days to one of the 133 VA Community Living Centers between January 2004 and June 2005, the latest data available for study.

Veterans in dementia units had 66 percent greater odds of receiving an antipsychotic and residents with aggressive behavior had nearly three times greater odds of receiving an antipsychotic. By 2008, the Food and Drug Administration required label warnings about the increased risk of death among elderly people on all types of antipsychotics.

Kris Mamula covers health care, insurance and employee benefits for the Pittsburgh Business Times. Contact him at or (412) 208-3825.




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