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Health advocates are calling for tough new rules on the use of anti-psychotic drugs in Illinois nursing homes, including tighter controls on doctors who prescribe the powerful medications. An investigation by Tribune and ProPublica showed many frail and vulnerable Illinois nursing home residents have been unnecessarily dosed with anti-psychotics, leading to harm and an increased risk of death. One psychiatrist provided assembly-line care to thousands of mentally ill patients. The FDA has approved anti-psychotic drugs to treat serious mental illnesses, such as schizophrenia, but doctors may also prescribe them to geriatric patients with other conditions, such as dementia, in a common but controversial practice called "off-label" use. Wendy Meltzer of Illinois Citizens for Better Care, an advocacy group for nursing home residents, suggest one way to stop nursing home doctors from using the drugs to "chemically restrain" residents is for the state to refuse to pay for certain medications. Meltzer also stated that the state should not pay for multiple antipsychotics for the same residents or for psychotropics at dosages over the recommended limits without prior approval. Documents show that hundreds of nursing residents have been given psychotropics without their permission since 2001. Meltzer suggest nursing homes use standardized consent forms for each psychotropic drug. Investigation of Chicago psychiatrist Dr. Michael Reinstein revealed yet other issues. Although Illinois law requires psychiatric hospitals to report patient deaths, three deaths of people under Reinstein's care were never reported. Although the Department of Public Health grants and revokes the licenses of psychiatric hospitals, it cannot levy penalties for lax death reporting because that law is on another agency's books. Advocates said inconsistencies like this should be fixed. Advocates are also asking Illinois lawmakers to require drugmakers to publicly disclose payments to doctors so that their patients can be aware of possible conflicts of interest. The investigation showed that one pharmaceutical company gave Reinstein nearly $500,000 to promote a drug that Medicaid records suggest he prescribed 41,000 times. Reinstein has disputed those figures. State Rep. Jack Franks, D-Marengo, has pushed a bill since 2005 requiring drugmakers to report the amount of money and gifts they give to doctors, nursing homes and hospitals. The bill has not passed, but he said he plans to re-introduce it next session. www.chicagotribune.com/health/chi-psychotropics-reformdec20,0,3977364.story
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