• Michelle L Ellis, Victor Molinari, Debra Dobbs, Kelly Smith, and Kathryn Hyer.
• School of Aging Studies, University of South Florida, Tampa, Florida; Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida.
• Aging Ment Health. 2015 Jan 1;19(6):507-16.

ObjectivesAntipsychotic medications have been federally regulated since 1987, yet research suggests they continue to be used inappropriately to alleviate behavioral symptoms associated with dementia. In 2012, the Centers of Medicare and Medicaid launched a new initiative to reduce antipsychotic medication in nursing homes by 15% nationally. The aim of this study was to examine qualitative data to explore strategies that have been implemented, to assess which strategies are evidence-based, and to make recommendations to improve upon practices to reduce antipsychotic medication use.MethodA convenience sample of 276 nursing home professional staff members were surveyed about these topics using open-ended questions.ResultsTheme-based content analysis yielded three main themes. The themes related to changes in practice included the following: (1) increased review of resident behavior and antipsychotic medication regimens; (2) reduction in antipsychotic medications or dosage; and (3) increased use of nonpharmacological interventions. The main themes relevant to needed assistance included the following: (1) education; (2) clinical support; and (3) increased financial resources and reimbursement.DiscussionOverall findings indicate that the majority of facilities are actively responding to the initiative, but challenges remain in education, finding mental health support, and in reimbursement.

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