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. 2021 Jul;29(7):704-708.
doi: 10.1016/j.jagp.2020.11.008. Epub 2020 Dec 1.

Unreported Antipsychotic Use Increasing in Nursing Homes: The Impact of Quality-Measure Exclusions on the Percentage of Long-Stay Residents Who Got an Antipsychotic Medication Quality-Measure

Jonathan D Winter  1 , John William Kerns  2 , Katherine M Winter  3 , Alicia Richards  4 , Roy T Sabo  4
Affiliations

Unreported Antipsychotic Use Increasing in Nursing Homes: The Impact of Quality-Measure Exclusions on the Percentage of Long-Stay Residents Who Got an Antipsychotic Medication Quality-Measure

Jonathan D Winter et al. Am J Geriatr Psychiatry. 2021 Jul.

Abstract

Objective: Excluded from reporting to CMS's Percentage of long-stay residents who got an antipsychotic medication quality-measure are antipsychotics prescribed to nursing home patients with schizophrenia, Tourette's, or Huntington's. Over the 4 years following its 2012 debut, the quality-measure calculated a 27% reduction in inappropriate antipsychotic use but also an 18.3% increase in exclusion claims. This study evaluated the impact of these exclusions on the measure's findings.

Methods: Claims data for the years 2011-2016 retrospectively identified the prevalence of schizophrenia, Tourette's, and Huntington's in quarterly cohorts of Virginia long-stay residents prescribed antipsychotics. Annualized diagnoses in 2011 were compared with subsequent years using simple logistic regression.

Results: In 2016, 29% of the antipsychotics prescribed in Virginia nursing homes were to residents with diagnoses of schizophrenia, Tourette's, and Huntington's, a significant 32% increase from 2011.

Conclusion: Almost 30% of the antipsychotics employed in Virginia nursing homes are excluded from CMS's long-stay antipsychotic quality-measure.

Keywords: CMS; antipsychotic; capitalize huntington's; huntington's disease; long-stay; nursing home; quality measure; schizophrenia; tourette's; tourette's syndrome.

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