Abstract
Use of antipsychotic medication to manage behavioral and psychological symptoms of dementia, associated with significantly increased mortality, represents an international quality and safety challenge. In the US, state and national campaigns for reduced antipsychotic use in nursing homes were launched beginning in 2012. Antipsychotic use for long-stay residents declined from 23.9% in 2011 to 17.0% in 2015 (fourth quarter), a relative decrease of 28.8%. State quality improvement strategies varied widely, some relying more on education and others on regulation. In this presentation, we will discuss the approaches taken by several of the state initiatives, and impacts to date. We will discuss the effectiveness of different states’ improvement strategies, and provide updated regression analyses on the impact of staffing and other facility characteristics on antipsychotic use and on improvement rates. Implications for effective, large-scale, sustainable quality improvement strategies, and roles of educational and regulatory components, will be discussed.