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August 5, 2013

Legislation seeks better monitoring of drug treatments

State Sen. O'Connor Ives files bill in response to treatment of some Alzheimer patients

(Continued)

As much as 14 percent of nursing home residents had Medicare claims for those types of drugs. O’Connor Ives said that in Massachusetts, the percentage is close to a quarter.

“Massachusetts is out of synch with the majority of states in the country in terms of the sheer number of residents being administered these drugs,” she said.

O’Connor Ives said that the serious health risk, and evidence that some nursing homes are using the drugs as treatments for unruly patients with Alzheimer’s or dementia, means informed consent should be mandatory and should extend to the family or designated health care proxy.

“The real goal here is informed consent,” O’Connor Ives said. “These patients are vulnerable and the pattern we’re seeing is psychotropic drugs are being administered not because they’re medically necessary, but because they sedate or quell a patient who might need additional supervision.”

James Ellison, director of the geriatric psychiatry program at McLean Hospital and a member of the Massachusetts Psychiatric Society, testified to the committee about the use of psychotropic drugs in long-term care. In an interview, he said he is hesitant to support the proposals as they are written. He agreed that antipsychotics can be dangerous and that the patient, or the patient’s health care representatives, in the event the patient is not competent, should be informed about the use of these drugs.

“It’s well known that these are powerful and potentially dangerous medicines and they should be given only to individuals whom they will benefit and even then only for the shortest amount of time necessary and in the smallest doses that are effective with informed consent and effective monitoring,” he said.

The three different bills, written by O’Connor Ives, Sens. Bruce Tarr, R-Gloucester, and Patricia Jehlin, D-Somerville, are in the early stages of consideration.

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