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Texas Decreases Use of Antipsychotic Drugs in Nursing Facilities

Statewide Effort Improves Long-Term Care Residents’ Well-Being

AUSTIN – Texas has decreased its use of antipsychotic drugs in nursing facilities by 58 percent – more than any other state, according to a report from the National Partnership to Improve Dementia Care in Nursing Homes.

“Reducing the use of these medications directly improves the quality of residents’ life in nursing facilities, and we are proud of this result,” said Stephanie Stephens, state Medicaid director at Texas HHSC.  “We have worked closely with providers to educate them on the use of these medications and on alternative strategies to address behavioral issues with residents, particularly those with dementia.”

Texas now ranks 11th in the nation in terms of reducing prevalence of antipsychotic drug use for long-term-care residents. A key measure of nursing facility quality — and one tracked closely by the Centers for Medicare and Medicaid Services — is the use of antipsychotic medications for residents, particularly those with dementia.

In 2011, Texas was ranked 51st in the nation for highest use of antipsychotic medications, with 28.8 percent of nursing facility residents receiving antipsychotic medications.

Since that time HHSC launched several initiatives to reduce the use of antipsychotic medications in nursing facility residents, including implementing specialized training programs focusing on dementia care for nursing facility providers and staff, creating an online toolkit for licensed vocational nurses, and establishing the Center for Excellence in Aging Services and Long-Term Care, a collaboration between HHSC and The University of Texas at Austin School of Nursing that provides web-based training and resources for best practices in geriatrics and disabilities.

The collaboration between HHSC, providers, advocacy groups, industry groups and many others has resulted in a significant, sustained reduction in the use of antipsychotic medications. At the same time, starting in 2015 HHSC identified an increase in new diagnoses of schizophrenia in Texas nursing facility residents. HHSC convened a workgroup of stakeholders and partners to address this and discuss the state’s shared commitment to working collaboratively to ensure accurate diagnoses and quality of care.

The Texas HHS Office of the Long-Term Care Ombudsman also educated residents on the use of antipsychotics. The program published an educational brochure for residents, family members, and facility staff to ensure residents were only getting prescribed these powerful drugs with an appropriate diagnosis.

“Texans deserve to be supported in the care planning process, and we have worked closely with residents and families all over the state to ask questions about the purpose of a new prescription, help residents communicate any side effects of a drug, and support residents with seeking alternatives to antipsychotic drugs when possible,” said State Long-Term Care Ombudsman Patty Ducayet.

Other efforts to decrease antipsychotic use in Texas have included the implementation of the Music and Memory program, which provides MP3 players to seniors with dementia to help them reconnect with the world through music-triggered memories, which can improve quality of life and quality of care. The program was launched in 2015 as a pilot program in nursing facilities and at HHSC’s state supported living centers and Austin State Hospital in 2016. Since then, more than 1,000 nursing homes across Texas have taken part in the HHSC Music & Memory program. For more information on the Music and Memory program, visit the HHS website.