Antipsychotics - pub domainIn February 2016, the Globe and Mail reported on a new study from the Canadian Institute for Health Information (CIHI) investigating the over-prescription of antipsychotic drugs to Canadian seniors living in long-term care facilities. The study found that nearly half of residents were prescribed antipsychotics, and that of those more than 20 per cent were “chronic users.” Although antipsychotics are generally not approved to treat dementia, long-term care facilities are prescribing them “off label” to treat the symptoms of not only dementia, but also schizophrenia and other forms of psychosis.

Antipsychotic over-prescription is of serious concern to experts who believe the drugs are used to sedate aggressive or uncooperative seniors. According to Mary Schulz, director of education at the Alzheimer Society of Canada, the over-prescription of anti-psychotic drugs results in more effective treatments being left unused. A number of institutions in Canada and abroad are developing “person-centred” responses to problems with violence, aggression and abuse tied to dementia.

“There are tremendous risks associated with antipsychotic use,” Schulz told the Globe, “particularly in people who are … quite frail.”

In May 2016, the Canadian Foundation for Healthcare Improvement (CFHI) released the results of a
“pan-Canadian” study which attempted to reduce the “inappropriate use of antipsychotic medication among seniors in long term care.”

The results were fairly explicit: “fewer falls, less aggressive behaviours and resistance to care, and an improved quality of life for residents and their families.”

“Antipsychotics are often used in patients with dementia to curb resistance to care and other challenging behaviours,” explained CFHI Vice President, Programs, Stephen Samis in a release. “But they provide limited benefits and can cause serious harm and complications from overuse – especially falls, which ultimately lead to unnecessary visits to the emergency room. With this initiative to reduce use [long-term care] providers report improved care for residents and a better culture at their facilities. Most important, family members say they now have their loved ones back.”

With studies showing that more than a quarter of Canadian seniors in long-term care facilities have been prescribed antipsychotics without a psychosis diagnosis, the CFHI’s study could deliver game-changing results on a national scale. According the foundation’s May 16 release, a national initiative could theoretically reduce or discontinue antipsychotic prescriptions for 35,000 seniors; prevent 91,000 falls, 19,000 emergency room visits, and 7000 hospitalizations; and save as much as $194 million in direct healthcare costs, even after the costs of implementing the program are taken into account.

The CFHI’s study also allayed fears that reducing antipsychotic prescriptions would lead to an increase in aggressive or violent behaviour: “Aggression is what typically triggers the use of antipsychotics in the first place,” Samis said. “Our initiative not only showed a notable decrease, it took that issue off the table.”

If a member of your family is suffering or has been injured as a result of a serious medication error like the over-prescription of anti-psychotic drugs, contact the Medical Malpractice Group at Neinstein Personal Injury Lawyers today. They can advise you on your legal options and help to make sense of the damages you have incurred.

Greg Neinstein