Audit puts spotlight on pharmacy role in reducing antipsychotics for dementia care
Results of a large-scale audit of a two year dementia care pilot highlight the positive role specially trained pharmacists can play working alongside GPs, nurses and care home workers to better manage the appropriate use of antipsychotic medicines for people with dementia in care homes.
Posted: 4 June 2014
The audit was undertaken by selected Boots UK pharmacists, some of whom had received additional Alzheimer’s Society training to enable them to better support people with dementia and their carers.
In the audit over one quarter (26%) of the care home residents reviewed did not have any symptoms requiring a regular antipsychotic medication, and in almost two-thirds of cases (58%) the risk of the medication was deemed to outweigh the benefit. The audit also resulted in over 20% of residents having their antipsychotic dose reduced, and more than 17% had their antipsychotic medication discontinued.
The audit of the community pharmacy led pilot service has been published in Nursing Times today. David Wright, Professor of Pharmacy Practice at the University of East Anglia and one of the study authors, comments, ‘Reducing the use of antipsychotic drugs for people with dementia is a government priority, and this audit has shown that collaborative working between pharmacists, GPs, nurses and care home staff is a key way of addressing this objective. Pharmacy is an underused resource within the NHS and this latest research demonstrates a valuable role community pharmacists can play in improving patient care’.
Asif Aziz, Director of Care Services, Boots UK, said, ‘Better medicines optimisation has been identified as a key way to supporting patients more effectively and we know that it can make a real difference to patient’s lives – especially those living with long term conditions. This pilot demonstrates how, if commissioned at a national or local level, pharmacy could play a crucial role in supporting patients to get the most from their medicines – whether that is via one of our stores or through one of our many dispensing services within the community’.
Alistair Burns, National Clinical Director for Dementia, NHS England, said the audit ‘underscores the key role that pharmacists have in optimizing prescription of medication in this potentially vulnerable population’. Dr James Pickett, Head of Research at Alzheimer’s Society said it has ‘long campaigned for alternatives to antipsychotic medications as they are potentially harmful and can worsen the symptoms of dementia’. The audit ‘highlights the important role that community pharmacists can play in making sure these alternatives are considered. We’ve seen a 50% reduction in the prescription of anti-psychotics to people with dementia in recent years and, in light of this new evidence, we hope this trend will continue.’
The community pharmacy-led service audit evaluated the use of antipsychotic medicines across 463 care homes over a two year period. Community pharmacists, including those specially trained by Alzheimer’s Society, worked alongside the healthcare professionals responsible for people with dementia within care homes to create an action plan for the use of antipsychotic medication in line with NICE guidance.
The study was commissioned by Boots UK to demonstrate the potential added value that community pharmacy can offer, and the significant contribution that their service could make to the NHS. Since the audit was undertaken, the government has launched the G8 Dementia Challenge and is currently updating the National Dementia Strategy which aims to deliver major improvements in dementia care by 2015.