Dementia: DH promises targets to cut use of antipsychotics

The government has promised to set targets to reduce the use of antipsychotic drugs for people with dementia after a long-awaited review found inappropriate prescriptions were widespread.

The Department of Health has also promised to improve access to psychological therapies for people with dementia to tackle the aggression and agitation that are leading to prescriptions of antipsychotics.

There are longstanding concerns that the use of antipsychotics may hide the onset of dementia and increase the risk of stroke and death.

No new money

However, no new money has been promised to implement the measures.

The review, carried out by Professor Sube Banerjee, the government’s senior professional advisor on older people’s mental health, found National Institute of Health and Clinical Excellence guidance was being breached in the prescription of antipsychotics.

Banerjee said: “Antipsychotics are used too often in dementia; up to two-thirds of the estimated 180,000 people with dementia receiving these are prescribed them unnecessarily.”

The DH also confirmed that it would appoint a national clinical director for dementia as part of its response to the review.

‘Landmark’ review

The Alzheimer’s Society, which has long campaigned for action to tackle overuse of antipsychotics, welcomed the “landmark” review.

Chief executive Neil Hunt said: “The report suggests prescriptions could be reduced by two thirds in three years; this is vital and the new action plan cannot afford to fail. Change will only be achieved with commitment from government, primary care trusts and health professionals and clear local targets.”

The DH said an audit would be carried out to establish definitive prescribing figures, and then targets would be set to cut use.

Probe announced in June 2008

The review was announced in June 2008, alongside the consultation on the national dementia strategy for England, and was originally due to be completed last year.

When the strategy was published, in February 2009, it said the drugs review was likely to report in spring 2009.  However, the review remained unpublished over the summer causing outcry from dementia charities.

Last year, the all-party parliamentary group on dementia found that up to 105,000 people in care homes were being inappropriately given antipsychotic drugs, at an estimated cost of over £60m a year.

In May 2009, the Care Commission and Mental Welfare Commission in Scotland called for a review into their use after it found many residents in Scottish care homes were being left on the drugs without review.

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