Invatech's technology facilitates major research study into the overprescribing of antipsychotic medications in care homes
The results were published in the BMJ Open online journal in 2016 of a study conducted between 2009-1012 amongst 31,619 residents in 616 care homes by a team of academics from Warwick, Coventry and City universities. The study set out to examine the long-term impact on antipsychotic prescribing in care homes following the government’s 2009 National Dementia Strategy (NDS), which recommended a review of their use in light of potential serious side effects.
At the time of the study, it was estimated that 46% of new admissions to care homes are for reasons of dementia (Centre for Policy on Ageing, 2012) and that more than one third of people with dementia (36.5%) now live in care homes (Alzheimer’s Society). There is evidence of ‘off-label’ prescribing (using medicines for uses other than those approved by medical licensing authorities) of antipsychotics for behavioural and psychological symptoms in dementia (Psychiatric Bulletin, 2007 and Journal of the American Geriatrics Society, 1988). These antipsychotics were originally developed for use in patients with schizophrenia or psychosis and are not licensed for use in dementia care.
The research showed that no statistically significant difference could be observed in prescribing patterns (prescribing rates, antipsychotic agent types and length of treatment) across the sample of 616 long-term care institutions. 77 per cent of prescriptions in 2012 were ‘excessive’, up from 69.7 per cent in 2009. Their use was deemed ‘excessive’ if patients had been on them more than the maximum six weeks recommended by government guidelines. The team of academics found that many patients stayed on the antipsychotic medications for more than a year and very often until they died. They said that often care home staff were urging GPs to prescribe the medication to difficult patients they were struggling to control.
Professor Clive Bowman, Chairman for Invatech commented:
“Our study shows that the National Dementia Strategy has failed to have a sustained effect on the excessive prescription of antipsychotic medicines for people resident in care homes. This is unacceptable, clear standards are required regarding the use of these drugs and a designated responsibility for monitoring medicines and their usage mandated. New technology can do this in real time, allow public scrutiny and free professional time to promote best practice.”
There are around half a million adults in care homes in England and almost half have been diagnosed with dementia. The study has also revealed that many patients were being given drugs which aren’t even licensed to be used for dementia. These are medications which are meant to be used for other illnesses and their side effects for dementia patients have not been rigorously checked.