News

Exclusive: GPs face sanctions on dementia prescribing

26-Jun-08

GPs could face sanctions for prescribing anti-psychotic drugs when there is no alternative, as ministers pledged a 'zero tolerance' crackdown on their use.

Dementia experts warned that GPs are under pressure to prescribing the drugs because of a lack of specialist units to refer dementia patients to, and requests from care homes.

This follows a BBC investigation which found that more than half of 355 surveyed GPs were still prescribing the drugs risperidone and olanzapine despite safety concerns.

In March 2004, the MHRA advised against using the drugs to treat dementia after they were found to raise stroke risk.
Speaking at the launch of the DoH's national dementia strategy in London last week, health minister Ivan Lewis called for ‘zero tolerance'.

‘We have launched an immediate review into the prescribing of anti-psychotic drugs and we need to be clear about the reasons why this is happening and the scale of the problem.'

Neil Hunt, chief executive of the charity Alzheimer's UK told GP that if GPs persistently prescribed anti-psychotics there was a case for sanctions.

Dr Tim Kendall, director of the National Collaborative Centre for Mental Health, said they should ‘face the GMC'.

But Dr Chris Manning, chief executive of the charity Primary Care Mental Health and Education, said poor training of care home staff means GPs cannot cut prescribing, although the drugs are inappropriate in some cases.

‘We cannot simply change practice through sanctions,' he said.

North Shields GP Dr Dave Tomson, who has an interest in mental health, said antipsychotic drugs were a last resort, but vital if patients risked harming themselves or others.

‘Calling for a zero tolerance to these drugs suggests a woeful lack of awareness of the complexities of mental health.'

Lizzie McLennan, policy officer at Help the Aged, said care homes were often understaffed forcing the carers to rely on giving patients drugs instead of one-to-one care.

sanjay.tanday@haymarket.com

Comment below and tell us what you think

Comments

Paula Gardiner

26/06/2008

Sanctions would be better placed on those commissioning and those providing care in care homes to ensure they train and staff their homes appropriately. GP's in the main are doing their best to reduce the risks and stresses encountered by residents in homes where the quality of care is in doubt.

C W Spencer

26/06/2008

Most GPs I chat to do not want to prescribe these medications. But the carers and the employers are very clear that they cannot cope with things as they are- and they usually make notes and are quite clear what they cannot cope with (probably) honesty in most cases. They present very compelling cases for intervention. I now get mental health team input with confirmation of approved action by a psychiatrist. The situation is made know to the patient as far as is possible and also to the relatives and staff of the home. If there is not general agreement then further pyschiatric imput is sought to try to keep the patient from secondary care and to allow a defence to be built up in case of patient or staff injury. Tedious and expensive but ethically probably as correct as is possible.

Niall Finegan

26/06/2008

Small doses of antipsychotics are occasionally necessary for the quality of life for the patient, their relatives, the carers and the staff and importantly other individuals who spend their lives in proximity to disturbed people. The other residents

Removing judicious use of these drugs would be a retrograde step and not in the best interest of good clinical practice

cynic

29/06/2008

Why do successive goverments/intitutions NEGLECT our elderly? Have they NOT contributed to the wealth and welfare of the current population? It is SHAMEFUL that they are sidelined, marginalised and worst of all treated like lepers when it come to offering them any form of service whether it is health, banking, insurance you name it.

IT is time that the nation woke up to its duty and look after our elderly rather than shun them.

Only registered users may comment. Log in now or register for a free account.