Unnecessary and Dangerous

McKnights reported on a new study conducted to lower the prescription of quetiapine, an antipsychotic drug. Quetiapine is the most popular antipsychotic drug prescribed in the United States, and is often used off-label for patients with dementia to address behavioral symptoms. The risks include death, weight gain, cognitive decline, and falls.

For this experiment, Medicare sent 5,055 letters to primary care doctors who were the top prescribers of the drug. 2,528 got a placebo letter while 2,527 were at random to relieve three warning letters to let them know that their prescription of Quetiapine was high. Data was taken from 84,881 patients in nursing homes and 261.288 patients living in the community who all use Medicare.

The use of Quetiapine among nursing home residents dropped 7% and 15% for community-dwelling patients. The original study reduced prescription of the drug, but a small number of people studied and had limited outcomes. The new study tested the efficacy of letters in more people and focused on the indicators of dementia.

Michelle Harnisch, research student and first author of the study, said

“People with  dementia living in nursing homes and in the community were prescribed less and we did not detect negative health impacts for these groups.”

Adam Sacarny, PhD, an author and assistant professor of Health Policy Management at Columbia Mailman School, said

“Our study shows that low-cost letter interventions can safely reduce antipsychotic prescribing to patients with dementia.”