A new large-scale study scrutinizing psychiatric prescribing finds clinicians continue to give high-risk drugs to Medicare dementia patients—most of the time with no documented justification at all.
WARNING: Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. —Food and Drug Administration
And a new study published in the Journal of the American Medical Association (JAMA) reports that clinicians prescribe these drugs to roughly 25 percent of Medicare beneficiaries diagnosed with dementia.
That means one in four elderly Medicare beneficiaries with diagnosed dementia take pills known to carry serious risks, which can leave older adults drowsy and confused, unsteady on their feet and more prone to falls.
In the worst case, antipsychotics can even cause death, according to FDA warnings.
Clinicians were about twice as likely to prescribe psychotropics when there was no documented reason whatsoever than when there was one.
The study found doctors prescribed these drugs to over two-thirds of patients without any documented justification—no condition, symptom or circumstance that would justify prescribing the drugs—despite their known dangers. In other words, clinicians were about twice as likely to prescribe psychotropics when there was no documented reason whatsoever than when there was one.
“You would think it would be the opposite,” said Harvard Medical School’s Anupam Jena, a professor of health care policy.
No kidding.
The study’s senior author, Dr. John N. Mafi, was even more direct. Authorizing dangerous drugs without even so much as a purported justification to such a wide population of often helpless individuals can constitute, as he puts it, “inappropriate and harmful prescribing.”
These are “not trivial drugs,” he added. Some “actually have an FDA black box warning because they almost double the risk of death in patients with dementia.”
As people age, their ability to metabolize drugs changes, and they become more “susceptible to the toxicities of drugs,” Mafi explained. Older adults also tend to take multiple medications, increasing the risk of dangerous interactions.
