Dementia drugs review: 1800 deaths caused by antipsychotics

Eighteen hundred people with dementia are dying each year in the UK as a result of being prescribed antipsychotic drugs, according to a Department of Health-commissioned review.

The probe, led by government adviser Professor Sube Banerjee, also found that just one in five of the estimated 180,000 people with dementia being precribed antipsychotics derived any benefit from them.

The drugs are prescribed to manage the psychological and behavioural symptoms of people with dementia, such as agitation, aggression, wandering and shouting.

However, today’s report said that systems developed to manage these symptoms had grown “by chance rather than by specific planning or commissioning” to the detriment of patient care.

The report estimated that prescriptions could be reduced by two-thirds if appropriate support were made available.

Recommendations accepted

The government has accepted all of Banerjee’s 11 recommendations to “reduce the use of these drugs to the level where benefit will outweigh risk”.

In his foreword to the report, Banerjee highlighted his recommendation for each primary care trust to commission its local older people’s mental health service to provide support to care homes, where use of antipsychotics is prevalent.

The report said this would require six extra full-time members of staff in community mental health teams for older people in the average PCT, so teams could visit care homes regularly and respond to crises.

The report said it would cost £68m a year in England to implement, but said the cost could be offset by an estimated £55m saving through a two-thirds cut in the use of antipsychotics and reduced admissions to hospitals.

Care services minister Phil Hope said that no new money would be made available to implement Banerjee’s recommendations.

He said “substantial resources” were already available, adding: “It’s about making sure that the money that is being spent is spent well”.

New national clinical director

A number of Banerjee’s recommendations will be taken forward by a new national clinical director for dementia, a post announced at last month’s National Children and Adult Services Conference, that should be filled in January 2010.

The DH said that the director would report on a six-monthly basis to the care services minister on progress against the report’s recommendations and lead a national audit to generate data on drug prescription levels.

This should be completed within six months of the director taking office and then repeated on an annual basis for at least three years, as recommended in the report.

The report was orginally due to be completed last year and published earlier this year.

At a press conference to launch the report, Hope explained the delay by saying: “We wanted to make sure that the report was properly peer reviewed and I’m delighted that we’ve got a report that is robust.”

• Community Care is running a conference on dementia on 11 February 2010 in central London. Living well with dementia marks the first anniversary of the national dementia strategy.

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