The burden of psychotropic drug prescribingin people with dementia: a populationdatabase study.
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.
Guthrie
Bruce
B
Quality, Safety and Informatics Research Group, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, UK. b.guthrie@chs.dundee.ac.uk
Clark
Stella Anne
SA
McCowan
Colin
C
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
D011619:Psychotropic Drugs