title: Diagnostic rates and treatment of dementia before and after launch of a national dementia policy: an observational study using English national databases.
abstract: OBJECTIVE
  To assess the 2009 National Dementia Strategy's (NDS) impact on dementia diagnosis and treatment.
  
  
  METHODS
  Primary care data for England before and after launch of the NDS.
  
  
  METHODS
  We used nationally available data to estimate the trends over time in rates of dementia diagnoses recorded on the Quality Outcomes Framework (QOF) in Primary Care Trusts (PCT) and antidementia medication prescriptions from 2006/2007 (the first available figures) and the associated increase in cost relative to all other prescriptions. To establish PCT general practitioner (GP) QOF dementia recording validity, we correlated it with medication prescription using the NIC (net ingredient cost).
  
  
  RESULTS
  Regression analysis showed that dementia diagnosis rate was lower prior to launch of the NDS and increased significantly after it was launched. The number of antidementia prescriptions and the cost of antidementia drugs relative to total PCT prescribing costs increased significantly after 2009. GP recording of dementia diagnosis correlated highly with prescription of cholinesterase inhibitors and memantine in the same area (p<0.001 each year).
  
  
  CONCLUSIONS
  The launch of the NDS was associated with a significant increase in dementia diagnosis rates and prescriptions of antidementia drugs. We cannot establish the causality but this was a change from the prelaunch pattern. Further assessment of any intervention to increase the diagnoses should include an assessment of harm as well as potential benefit.
authors.affiliation: Mental Health Sciences Unit, UCL, Charles Bell House, London, UK.
authors.forename: Naaheed
authors.initials: N
authors.lastname: Mukadam
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
authors.forename: Khadija
authors.initials: K
authors.lastname: Rantell
authors.forename: Sam
authors.initials: S
authors.lastname: Rickman
mesh_terms: D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D016208:Databases, Factual; D003704:Dementia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004739:England; D006291:Health Policy; D006801:Humans; D008559:Memantine / Q000627:therapeutic use; D011320:Primary Health Care
chemical_list: D002800:Cholinesterase Inhibitors; D008559:Memantine
keywords: Public Health