Polypharmacy is Linked to Increases of Adverse Effects in Nursing Homes

A recent study in the Journal of American Medical Directors Association has proposed that the use of multiple medications on patients, sometimes for off-label purposes, is a significant practice in nursing homes and may lead to adverse drug effects such as falls and delirium. This practice is referred to as polypharmacy and is reportedly widespread in nursing homes across America, with as much as 40.3 % of residents being given inappropriate prescriptions.

The overuse of these medications is particularly prevalent among psychotropic drugs such as antidepressants and antipsychotics. According to the study, between 50 and 80 percent of nursing home residents are prescribed at least one psychotropic drug. The use of antidepressants has increased among older residents as well, with a reported 49% of US nursing home residents being administered these drugs. Antidepressants are known to cause a multitude of adverse affects such as serotonin syndrome, falls, hypnatremia, delirium, gastrointestinal bleeding, and osteoporosis.

Despite growing evidence of morbidity and mortality, antipsychotic drugs have become the dominant medication in treatments of behavioral and psychological symptoms of dementia. Recent surveys have found that 1 in 3 nursing home residents are treated with antipsychotics, even though the efficiency of antipsychotic drugs is limited, with estimates between only one in three to one in five patients demonstrating significant improvement. Furthermore, the use of antipsychotic medication has been known to trigger numerous side effects such as delirium and unhealthy weight gain. Chronic understaffing in nursing homes coupled with the extensive use of antipsychotic medication for off label purposes can lead to the chemical restraint of patients. This morally reprehensible activity is a violation of the Patients’ Rights.

A study from the US national home survey also reported that 53.8% of all nursing home residents had hyper tension as a primary admission or as a current diagnosis. Of these residents, 84% were receiving at least one prescription for the complication, while 51.5% of those residents diagnosed with the condition were receiving two or more antihypertensive medications. Furthermore, there have been few trials that have included NH residents and even less that have proven a significant benefit to those residents.

The improvement in efficiency and safety of drug utilization in nursing homes has been increasingly seen as an essential element of high quality care in NH’s. This care can improve function and decrease mortality in seniors. Management of the prescription, purchase, storage, distribution, and administration of medications is an important factor in improving the health and lives of NH residents.


The Law Offices of Ben Yeroushalmi have dedicated attorneys that specialize in elder abuse litigation and nursing home neglect cases. If you or your loved one has been given inappropriate amounts of medication, we encourage you to contact one of our elder abuse specialists today. We serve many locations across California including but not limited to Agoura Hills, Bell Gardens, and Calabasas.