[A brief reference to this item appears in: Dementia and Elderly Care: the Latest Evidence Newsletter (RWHT), Volume 3 Issue 3, October 2012].
Antipsychotics prescribed for people with dementia are associated with approximately 1800 excess deaths in the UK annually. Reducing the prescribing of antipsychotics is a public health priority.
A project conducted at Medway Primary Care Trust (PCT) in the UK involved the dementia register being searched by a pharmacy technician to identify people with dementia prescribed antipsychotics, and then a trained specialist pharmacist performing targeted clinical medication reviews for these people where appropriate. Data from 59 practices showed 15.3% of 1051 people on the dementia register were receiving low-dose antipsychotics. People with dementia living in residential homes were 3.5 times more likely to receive an antipsychotic (25.5% of care home residents (118/462) compared with 7.3% of people living at home (43/589)). Of the 161 people with dementia prescribed low-dose antipsychotics, 91 were receiving on-going treatment from local secondary care mental health services or Learning Disability Teams. The remaining 70 patients had the antipsychotic withdrawn or the dosage reduced following the pharmacy-led medication review.
Overall 15.3% of people on the dementia register received a low-dose antipsychotics, and this may under-estimate the actual usage of antipsychotics in people with dementia. Antipsychotics are used more in care home settings. Pharmacist-led medication reviews can help to limit the prescribing of antipsychotics to people with dementia.
Child, A. Clarke, A. [and] Fox, C. [et al] (2012). A pharmacy led program to review anti-psychotic prescribing for people with dementia. BMC Psychiatry, September 25th 2012, Vol.12(1), 155. (Click here to view the PubMed abstract).