QOF could cut antipsychotic use for dementia patients

Study suggests scoring system could limit inappropriate use of antipsychotics for dementia patients.

Antipsychotic prescribing for dementia should be reviewed as part of the QOF to slash inappropriate use of the drugs, according to UK researchers.

A quality-of-care score developed by the researchers could be added to the QOF dementia domain to boost standards, they said. The study found 26% of patients with dementia were prescribed antipsychotics despite high rates of vascular disease. Antipsychotics can increase risk of vascular events such as stroke.

Just 57% had undergone a medication review in the past six months. It comes after the DH conceded in November last year that it had missed its target to cut antipsychotic prescribing by two-thirds within a year.

A University of Manchester team used data from existing QOF dementia indicators to assess GPs' annual reviews for dementia patients. They assessed whether GPs had completed all four components of the review, including checking mental health, medication, social care and discussion with carers.

Their findings covered 994 people with dementia from 52 practices in five PCTs. These showed that although most patients received an annual review, quality was variable.

Eight in 10 patients had received an annual review, and more than six in 10 had a discussion with carers. But just 51% had a social care review.

Patients were more than twice as likely to have had a review at a multihanded practice than a singlehanded one, they found. Researchers then scored practices by dividing the number of relevant clinical reviews provided by the number for which patients were eligible. They said this score could be added to the QOF dementia domain.

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