To bring up the other side of the coin from the original thread - elderly patients in homes receiving these meds. I've actually seen a decrease in this in my own experience. It seems that the black box warning drugmakers were required to put on antipsychotics used in dementia patients is having an effect. Seroquel, in particular, is being used less and less (again this is just my observation in my little pharmacy world) as a treatment for sundowning. The exception is with hospice patients, however, this doesn't bother me that much. Hospice patients are on hospice because they are dying. I believe that whatever makes this process more comfortable and less terrifying is the humane thing to do.
Jamila said:
To bring up the other side of the coin from the original thread - elderly patients in homes receiving these meds. I've actually seen a decrease in this in my own experience. It seems that the black box warning drugmakers were required to put on antipsychotics used in dementia patients is having an effect. Seroquel, in particular, is being used less and less (again this is just my observation in my little pharmacy world) as a treatment for sundowning. The exception is with hospice patients, however, this doesn't bother me that much. Hospice patients are on hospice because they are dying. I believe that whatever makes this process more comfortable and less terrifying is the humane thing to do.
Hm I wonder if anyone can find data about the larger picture when it comes to dementia patients being prescribed antipsychotics outside of the hospice care scenario. If this is actually a large-scale improvement that's a really exciting indication that a simple warning can curb inappropriate prescriptions.
That's a good step. I hope the other lawsuits in other states also go well. Although I wonder how the pay-out compares to the money this bullshit cost the state.
Grassley Continues to Investigate 'Overprescribing' to Medicaid Recipients
Sen. Charles Grassley APA is alerting district branches about letters sent on January 25 by Sen. Charles Grassley (R-Iowa) to 34 state Medicaid directors asking them to answer questions regarding how their states are overseeing physicians who are allegedly overprescribing pain-management and atypical antipsychotic medications. The letters were sent to states that provided some information in response to a 2010 letter from Grassley asking state Medicaid directors to identify top prescribers of these medications. Grassley continues to maintain that pain-management and atypical antipsychotic medications are being prescribed at inappropriately high rates and potentially serve as a way for physicians to abuse Medicaid. In the letters, Grassley asks state Medicaid directors whether the state's top prescribers are still allowed to bill Medicaid, whether the state has a system to monitor excessive prescription writing, whether a database to track drug sales and types of sales restrictions exists, and what kinds of interactions the state has had with the Centers for Medicare and Medicaid Services officials regarding the issue. States have until February 13 to respond. APA will closely monitor state responses.
This is the type of fiscal and moral responsibility I would like to see more of, but frankly, I'm a bit appalled that this level of oversight doesn't already exist. I don't doubt at all that there are gross abuses and over prescribing of drugs. Florida, for instance, prescribes Oxycodone at 5 times the national average, and on average, and 75% of all drug related deaths in that state are from prescription drugs.
Current actually made a documentary on this very topic:
This problem was largely due to the fact that Florida did not have a monitoring program in place, prompting many "patients" to travel from out of state, driving up prescription rates. Videos of like this one and other actions by lawmakers like Grassley have only just recently caused Florida to take action and curb the prescription pill problem. It's a good start, but it's really not enough. Monitoring doctors who bill Medicare will definitely prevent unnecessary prescriptions, however, there are still the overarching problems of addiction and abuse that require broader action to limit availability.
In many ways, this reminds me of the boom in methamphetamine use and manufacturing in the 90's. Policymakers saw that it was a growing problem (at least local law enforcement leaders kept telling them so), yet they failed to take action. What started in the West quickly became an epidemic and spread throughout the Mid-West and on to the East where local law enforcement were ill equipped or educated about the drug. While this was going on, sales of over the counter cold medication and other unregulated precursor chemicals used to manufacture meth were higher then ever (pardon the pun). Officials knew exactly why this was, yet it took forever for restrictions put in place. Even then, profits trumped policy after lawmakers reversed DEA rules (a remarkable rarity) to ensure that the drug companies would still be able to sell vast amounts of pseudoephedrine, albeit in individually wrapped blister packs.
mydogfarted
Oakland, NJ
June 2003
DEC 27, 2011 06:56 PM