GPs slash antipsychotic prescribing

Half as many patients with dementia are now prescribed antipsychotic drugs as five years ago, according to official figures.

Dementia: from 2006 to 2011, the proportion of all dementia patients prescribed antipsychotic drugs fell from 17% to just 7% (Photograph: Istock)
Dementia: from 2006 to 2011, the proportion of all dementia patients prescribed antipsychotic drugs fell from 17% to just 7% (Photograph: Istock)

The first ever NHS Information Centre audit of antipsychotic prescribing revealed a 59% drop in the number of people with dementia being prescribed antipsychotic medication between 2006 and 2011.

It shows GPs have succeeded in cutting inappropriate use of the drugs, which can cause serious side-effects. Estimates suggest as many as four in five prescriptions may be inappropriate.

A health minister welcomed the reduction but said more could be done. A charity described the drop as a 'momentous achievement'.

The audit shows how primary care is detecting and diagnosing more cases of dementia than ever before.

Newly diagnosed cases of dementia rose by 68%, from 18,762 to 31,455, between 2006 and 2011, the data show.

The audit examined mediation rates among 197,000 patients with dementia from more than 3,800 GP practices in England.

From 2006 to 2011, the proportion of all dementia patients prescribed antipsychotic drugs fell from 17% to just 7%.

Postcode lottery continues
But large variation persists between regions. Rates of antipsychotic prescribing were six times higher in the North West than in London.

The report's authors concluded: ‘The audit… shows that over the last six years there has been an increase in the number of people diagnosed with dementia.

‘Despite this increase, whether this is due to improved diagnosis coding and recording on practice clinical systems, the implementation of QOF or a natural increase in the number of people diagnosed with dementia, the audit suggests that the proportion of dementia sufferers receiving prescriptions of antipsychotic medication is decreasing.’

NHS Information Centre chief executive Tim Straughan said: ‘It is encouraging that prescribing of antipsychotic drugs is falling. However, it is clear that the picture nationally is mixed and that everyone involved in the care of those with dementia needs to look carefully at how they compare with others in their practices.’

Care services minister Paul Burstow said: ‘More than halving the number of people with dementia receiving antipsychotics marks a huge change in the right direction. It means tens of thousands of people will not be robbed of part of their lives to needless prescribing.

‘But we can and must go further. That is why we are developing a risk assessment tool to help doctors use the drugs safely and appropriately. I have also ordered the rerun of this audit to keep tabs on the action that is being taken to tackle the unacceptable regional variation that we have exposed.'

Jeremy Hughes, chief executive of the Alzheimer's Society, said: 'This momentous achievement is not just about statistics, it is about the lives of tens of thousands of people with dementia. Credit is due to the many doctors, nurses and care workers without whom this would not have been possible.'

GPs have been under pressure to cut antipsychotic prescribing from the government, which has set ambitious targets to reduce use in recent years.

In October 2010, the DH pledged to cut antipsychotic prescribing by two-thirds by November 2011, a target which was missed.

In June 2011, the Dementia Action Alliance (DAA), a group of 50 organisations including the RCGP, the Alzheimer's Society and the government, had warned inappropriate use of the drugs can worsen symptoms of dementia, leave patients unable to walk and increase the risk of stroke and premature death. NICE guidance says antipsychotic use should be a last resort.

The DAA had urged GPs to review all patients taking the drugs over the following nine months.

Last month, the MHRA joined these calls and said GPs needed to change prescribing habits.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us: