By Debbie le Quesne

Posts Tagged ‘drugs and the elderly

Shocking research over ‘cosh’ drugs prescriptions

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The health editor of The Guardian has published a worrying report, highlighting that prescriptions for drugs treating psychotic disorders soar among people admitted into residential care.

Only 1.1 per cent of elderly people still living at home take antipsychotic drugs, while the number tops 20.3 per cent for those in care homes, writes Sarah Boseley.

The so-called “chemical cosh” drug figures come from a study

in the Journal of the American Geriatrics Society, which looked at the prescribing of drugs to calm anxiety and sedate, as well as the antipsychotics which are supposed to be prescribed for severe mental health conditions such as schizophrenia and bipolar disorder and only for dementia as a last resort.

The Queens University, Belfast, researchers analysed information from the Northern Ireland prescribing database relating to over 250,000 people over the age of 65.

Yes, I know it’s a pattern that’s emerged in Ireland, but, the research says, the findings hold good for the whole of the UK.

Boseley writes: “They (researchers) discovered that only 1.1 per cent of elderly people living in the community in their own homes or with relatives were taking an antipsychotic – the so-called “chemical cosh” drugs, which the Medicines and Healthcare Products Regulatory Agency (MHRA) warns are not appropriate for most people with dementia.

“But in care homes, 20.3 per cent of residents were on them. They also looked at the dispensing records for those elderly people who made the move into care between January 2009 and January 2010 into care. Their medication shot up. In their own homes, 1.1 per cent were on antipsychotics, 7.3 per cent were on hypnotics – sedatives or mood stabilisers – and 3.6 per cent were on drugs for anxiety.”

The figures don’t get much better either. Once in a care home, 8.2 per cent were put on antipsychotics, 14.8 per cent were given hypnotics and 7.8 percent were prescribed anxiolytic. One year later, the amount of drugs they were on had jumped again and 18.6 per cent were on antipsychotics.

What is the link between the terrible hike in drug dispensing and residential care? Sadly the report does not draw conclusions. Clearly it cannot be explained by the continuation of drug use initiated in the community prior to entering care.

Lead researcher Aideen Maguire, who is based in the Centre of Excellence for Public Health Northern Ireland is reported in the article as saying: “With an ageing population globally it is important that we look at the reasons behind this type of increase following admission to care. Antipsychotic uptake in Northern Ireland is similar to that in the rest of the UK and Ireland, and this study highlights the need for routine medicines reviews especially during the transition into care.”

Do the figures reflect appropriate prescribing? We simply don’t know.

Are the homes to blame? No. Ultimately it’s doctors who prescribe, not carers.

It is time for the industry to press for fresh guidance on current drug review procedure with our GPs and NICE? I think so.


Written by debbielq

February 21, 2013 at 8:16 am