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'Wrong' drugs used for dementia

7 October 09 08:57 GMT

A quarter of nurses say dementia patients on general hospital wards are being prescribed antipsychotic drugs inappropriately, a poll reveals.

The survey of over 650 nurses and 450 nurse managers revealed widespread use of these powerful drugs, and sometimes purely to control "difficult" patients.

The Alzheimer's Society and 10 leading organisations called for government to publish its antipsychotics use review.

Research suggests the drugs double the death risk for many long-term patients.

Last year a report by the All Party Parliamentary Group on Dementia, found antipsychotics are inappropriately prescribed to up to 100, 000 people with dementia in care homes in the UK.

This could mean 23,500 people dying prematurely, according to a 2008 report by Paul Burstow MP.

Guidelines say the drugs can be given if the patient is severely agitated or violent. But critics say they are being over-used to keep patients sedated to make life easier for staff.

Neil Hunt, chief executive of the Alzheimer's Society, said: "The massive over prescription of antipsychotics to people with dementia is an abuse of human rights, causing serious side effects and increasing risk of death.

"These powerful drugs should only be used in a small number of cases. The Government must take action to ensure that these drugs are only ever used as a last resort.

"Carers of people with dementia who are currently on antipsychotics should talk to their GP or responsible consultant about whether it is appropriate to continue use."

Poor design

Dr Dave Anderson, chair of the Royal College of Psychiatrists' Faculty of Old Age Psychiatry, said the situation was "symptomatic of a health and care system ill designed for people with dementia".

"The staff in general hospitals need access to dementia training and advice from a specialist liaison mental health team for older people if we are to eradicate this problem."

He said 75% of hospitals do not have a liaison service for older people and that this had to change.

Dr Peter Carter, of the Royal College of Nursing, stressed the survey did not suggest that hospitals were awash with antipsychotic drugs.

But he said it was important that all staff administering the drugs received appropriate training and support.

A government review of antipsychotics was originally expected to be published in May, but was delayed.

A Department of Health spokesperson said the review was now expected to be published shortly.

The spokesperson said: "This is an important issue which directly affects the experience of people with dementia in all care settings, and we want to make sure that we get it right.

"NICE guidance is very clear - people with dementia who develop challenging behaviours should be assessed as soon as possible to establish the factors that are likely to generate, aggravate or improve such behaviour and a care plan should be put in place.

"People with dementia should only be offered antipsychotics if they are severely distressed or there is an immediate risk of harm to the person or others."

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