Reducing Off-Label Use of Antipsychotics in Nursing Homes: OASIS
Numerous studies have demonstrated serious health risks associated with the use of antipsychotic medication in older adults with dementia. In September 2012, Massachusetts Senior Care Association in collaboration with the Massachusetts Department of Public Health (DPH), launched the first of three one year initiatives aimed at safely reducing the off-label use of antipsychotic medication in treating nursing facility residents with dementia through implementation of OASIS, a curriculum authored by Dr. Susan Wehry, a geriatric psychiatrist and former Vermont Commissioner of the Department of Disabilities, Aging and Independent Living. The OASIS curriculum and training equips frontline nursing home staff with the knowledge, skills and attitudes to meet the needs of residents with dementia using non-pharmacologic approaches rather than medication.
The statewide initiative built on the success of an 11 facility OASIS pilot project in 2011, funded by the Commonwealth Corporation, which demonstrated positive outcomes for residents and statistically significant declines in antipsychotic use. Funding for the statewide OASIS trainings was made possible by a grant from the Massachusetts Department of Public Health, Bureau of Health Care Safety and Quality.
From 2012 – 2016, staff from 363 Massachusetts nursing facilities have participated in one or more of three rounds of statewide OASIS training, with additional participation from Massachusetts Department of Public Health surveyors, and nursing home ombudsmen from the Massachusetts Executive Office of Elder Affairs. Since OASIS training was first implemented, there has been a 29% total statewide drop in the rate of antipsychotic drug use for long stay nursing home residents from 2011 (baseline) through 2015.