title: The burden of psychotropic drug prescribingin people with dementia: a populationdatabase study.
abstract: OBJECTIVE
  to compare psychotropic prescribing in older people with dementia and the general elderly population.
  
  
  METHODS
  retrospective population database study in 315 General Practices.
  
  
  METHODS
  there were 271,365 patients aged > or = 65, of which 10,058 (3.7%) recorded as having dementia.
  
  
  METHODS
  epidemiology of psychotropic prescribing in older people with and without dementia; multilevel modelling of patient and practice characteristics associated with antipsychotic prescribing.
  
  
  RESULTS
  people with dementia were currently prescribed an antipsychotic drug (17.7%), an antidepressant (28.7%) and a hypnotic/anxiolytic (16.7%). Compared to the general elderly population, antipsychotic prescribing was 17.4 [95% confidence interval (CI) 16.4-18.4], antidepressant prescribing 2.7 (95% CI 2.6-1.8) and hypnotic/anxiolytics 2.2 (95% 2.1-2.3) times more likely in people with dementia. Most antipsychotic prescribing in people with dementia was prolonged (> 16 weeks). Patients living in more deprived areas and registered with larger and more remote practices were more likely to be prescribed prolonged antipsychotics.
  
  
  CONCLUSIONS
  over one in six patients are currently prescribed antipsychotic drugs known to be of little benefit and causing significant harm, with other psychotropics equally commonly used. Changing this will require investment in services to support alternative management strategies for people with behavioural and psychological disturbance associated with dementia.
authors.affiliation: Quality, Safety and Informatics Research Group, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, UK. b.guthrie@chs.dundee.ac.uk
authors.forename: Bruce
authors.initials: B
authors.lastname: Guthrie
authors.forename: Stella Anne
authors.initials: SA
authors.lastname: Clark
authors.forename: Colin
authors.initials: C
authors.lastname: McCowan
mesh_terms: D000368:Aged; D000375:Aging; D016208:Databases, Factual / Q000706:statistics & numerical data*; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011787:Quality of Health Care; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology
chemical_list: D011619:Psychotropic Drugs