Measuring use of psychotropic drugs in Veterans Affairs community living centers.

Abstract

To create an electronic reporting tool able to capture psychotropic medication use by residents admitted to Veterans Affairs (VA) community living centers (CLCs) and to compare data on frequency of use. Retrospective analysis using an electronic medical record (EMR) database. CLCs within the Veterans Integrated Service Network (VISN) 21, which encompasses northern Nevada, northern California, and Hawaii. 4,626 nonrespite care veterans admitted to a VISN 21 CLC between 2009 and 2012. Medication administration data from the EMR database was compiled into a reporting tool. Frequencies calculated were used in comparisons against Centers for Medicare & Medicaid Services (CMS) data for non-VA long-term care facilities and against previous local VA methods. The primary outcome was to develop a tool that would more accurately capture psychotropic drug use within VA CLCs. The secondary objectives were to use the tool to compare psychotropic use among VA facilities, against CMS data, and among various subgroups. There was a statistically significant difference when comparing psychotropic drug use for VISN 21 CLCs compared with use reported by CMS for non-VA long-term care facilities. Veterans in CLCs appear to use psychotropics at a significantly higher rate than residents in the community setting. Use of a real-time reporting tool can improve assessment of psychotropic drug use and create more realistic VA monitoring benchmarks.