It is entirely unrealistic to expect antipsychotics to only be prescribed for a diagnosis of psychosis. I see antipsychotics frequently used for patients/residents with dementia with agitation. It is not a first line treatment, but can be very effective, and can improve the quality of life of the resident. Certainly, any medication can be overused or used improperly, but I don't think there is any need to fear
their usage. The real horror show would be not
medicating these residents properly and safely.
I hope never to encounter the overuse of antipsychotic medications in the patients I care for. It is one of the big fears when I think of what kind of patient-care horror show I hope never to be exposed to.
I work in LTC, on a secure unit for residents with dementia. I checked the list, and my facility is included -- we are significantly below the national median for antipsychotic usage, HOWEVER, that is because it includes my entire SNF facility. Many of those residents that are there for short term rehab stays, and therefore won't be on antipsychotics (unless previously in use prior to admission...).
If they were to just look at the percentage for my floor,
our percentage would be much higher. Not 100%, but well over 50%, and I don't think any of those cases are unnecessary. I see a lot of scheduled Seroquel, Risperdal, and Zyprexa, along with scheduled and PRN Ativan. Our psych docs are very involved in the care of our residents. If we observe significant agitation/agression, we can request an evaluation, but the docs aren't likely to change meds/add antipsychotics unless we have a well documented pattern in the nurses notes.
Granted, I only looked at the listing and not the accompanying article, but I don't believe those percentages provide much info without additional data about the type of patient population that the facility serves. Just my thoughts...