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Tuesday, May 10, 2011

Misused Antipsychotic Drugs

Government finds nursing homes misuse antipsychotics -

Last evening on the CBS Nightly News,  Armen Keteyian reported on a longstanding problem at nursing homes.

This problem actually goes back for years and years, but as the type of drugs used to chemically restrain elderly people in these centers, problems are much more severe.

ABC Evening News reported on a similar issue in California in 2010.

Even before this, I reported on it because my brother, a METLife sales rep in Colchester VT and South Hero VT, outside Burlington, allowed this to happen to my mother.

In 2003 I spoke against the 7 drugs forced on my mother at Bentley Care Center in Naples FL, owned by Hyatt Corporation.

One of the drugs reported on in last night's news was Zyprexa.  My mother was forced to take Zyprexa.  This drug is NOT recommended for elderly, especially elderly women, because of the long half-life.

What was reported last evening referred to the 2005 Black Box warnings for these drugs.
The report by the Health and Human Services inspector general also found that antipsychotic drugs were given to nursing home residents "unnecessarily" over 300,000 times between January and June 2007, with more than half of those drugs (150,106) given "in excessive dose."

"The use of anti-psychotic drugs when they are not necessary is a form of restraint," said Dr. David Zimmerman, University of Wisconsin. "It's a form of chemical restraint."
The Department of Health and Human Services also says it's "very concerned" that there are "financial incentives for unnecessary drug use." In the past those incentives have led to charges of "kickbacks" between nursing homes, pharmacies and a drug company.

The newer class of drugs, atypical antipsychotics, such as Zyprexa (Eli Lilly & Co.) and Risperdal (Johnson & Johnson), already received the stronger warning labels in 2005, alerting the public about the potential for heart attack and pneumonia when given to the elderly.

In my mother's situation, she did not have dementia, at least initially.  Over drugging may have caused this to develop but Hyatt was not very forthcoming with information, except to say that if she was taken off the polypharmacy cocktail she would have to be moved to another facility.

Having been a Director of Nursing in several facilities I am well aware of the issues and the hair on the back of my neck rose every time I heard a new excuse from the Bentley DON.  It only showed she was willing to shut up for a pay check and not act to protect patient safety.  

This clearly links to the issue of financial incentives to nursing homes and Big PhRMA kickbacks.

What was also strange was that they had no drug interaction profile for the drugs.  The DON offered the excuse that their pharmacy did this. However, they would not identify the pharmaceutical supplier of their drugs, or supply me with any related data.

What was worse is that my brother refused to see that my mother had proper care.  He would not take her to a Naples neurologist I recommended because he would have to spend money to do so.  He also refused to accept the information I provided him that came from a top psych drug researcher (PhD RPh) at FDA, and a colleague of mine.

Later she had a fall and suffered a fractured hip.  A common side effect of over drugging the elderly. I suspect diabetes but Bentley failed to honor my access to information in the last years of my mother's life.

And to my brother, I am the bad sister who causes trouble.

I contacted the ABC affiliate in Naples after a story on a similar topic was aired in 2010.  They showed no interest in this story.  Their interest was in litigation.

Clearly, these drugs were not necessary in my mother's care.  More likely, they were given in excessive doses.

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