Dementia prescribing 'needs to be improved'

A University of Otago study has found that too many dementia patients are being prescribed "potentially inappropriate" drugs that increase the risk of delirium and death.

Lead author Dr Sharmin Bala, of the Otago preventive and social medicine department, is urging improvements to prescriptions and regular reviews to ensure safe prescribing.

The study findings indicated that "the quality of prescribing needs to be improved".

It was also imperative that medications prescribed to older people with dementia, particularly medications with anticholinergic side effects, were "reviewed regularly by medical professionals to ensure safe prescribing", she said yesterday.

Anticholinergics block a neurotransmitter in the central and peripheral nervous systems.

The researchers were "raising awareness" about a "concerning" situation in which some patients were being prescribed drugs which could increase the "risk of falls, delirium, worsening cognitive function and increased mortality", she said.

Given New Zealand's ageing population, issues about prescribing for dementia patients were becoming increasingly important.

There were an estimated 62,000 people with dementia in the country in 2016, a figure projected to rise to nearly 170,000 by 2050.

The study, co-authored by Dr Hamish Jamieson, of Otago's Christchurch campus, and Dr Prasad Nishtala, of the University of Bath, was published in the International Journal of Geriatric Psychiatry.

The research used data gained from more than 16,500 people throughout the country, aged 65 or older, who underwent an international resident assessment-home care assessment in 2015.

About 13% were diagnosed with dementia and, of those, about two-thirds (67%) had been prescribed potentially inappropriate drugs, including 40% who were prescribed anticholinergic drugs.

Anticholinergics are prescribed for many medical conditions, including for the treatment of overactive bladder, allergies and the management of symptoms in Parkinson's disease.

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