The percentage of dementia patients being prescribed antipsychotic drugs in England fell from 17% in 2006 to 7% in 2011, according to the first-ever national primary care audit on the issue.
However, during the period there continued to be strong variations in antipsychotic prescribing rates, which were up to six times higher in some areas than in others, says the National Dementia and Antipsychotic Prescribing Audit, which has been produced by the Health and Social Care Information Centre (HSCIC).
The audit analysed information about nearly 197,000 people with dementia submitted by more than 3,800 primary care practices in England, and its findings also show that:
- there was a 52% reduction in the number of people with dementia receiving a prescription for antipsychotic medication from 2008 to 2011;
- the number of people newly diagnosed each year with dementia in the participating practices increased by 68% from 2006 to 2011;
- there was a higher prevalence of diagnosed dementia in women (at 66%) than in men; and- at 95%, the majority of people diagnosed with dementia were aged 65 years and above.
Despite the general decrease in prescribing of antipsychotics to people with a diagnosis of dementia during the period, the study found that prescriptions for Johnson & Johnson's Risperdal (risperidone) rose nearly 9% during 2006-11. In contrast, the prescribing of four anti-dementia drugs, namely three acetylcholinesterase inhibitors - Eisai/Pfizer's Aricept (donepezil), Shire's Reminyl (galantamine) and Novartis' Excelon (rivastigmine), plus Lundbeck's N-methyl-D-aspartate (NMDA) receptor antagonist Ebixa (memantine) - shows little variation over the last six years.
Across the UK as a whole, there are approximately 750,000 people living with dementia, and an estimated 25% of them (180,000 people) are currently being prescribed antipsychotic medication. For around 36,000 people with dementia, these drugs are generally considered the right treatment option, but they are often prescribed inappropriately to people with dementia, say the report.
"This audit breaks new ground in examining prescribing patterns for dementia patients and highlights areas that GPs and other practices who want to deliver the best possible care need to focus on," said Tim Straughan, chief executive of the HSCIC.