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'Antipsychotic drugs used inappropriately'.

Byline: MARK SMITH Health correspondent

ANTIPSYCHOTIC medicines are being prescribed "inappropriately" to people with dementia in care homes across Wales, a major Assembly report has concluded.

The Health, Social Care and Sport Committee was told antipsychotics were increasingly being used to "manage" challenging behaviour of people with dementia.

Their report found that these drugs were often given out as a first option rather than a last resort - despite them carrying an increased risk of heart attacks and strokes for patients.

Studies estimate that there are at least 1,800 extra deaths each year among people with dementia as a result of their taking antipsychotics.

Dr Dai Lloyd AM, chairman of the committee, said there was also "considerable concern" over the lack of data and records which made it difficult to build up a national picture of prevalence.

He said: "We are not suggesting that antipsychotics should never be prescribed for people with dementia; it is the appropriateness of their prescription that is under question.

"Given the increased risk of heart attack or stroke associated with their use in people with dementia, we are very concerned that in many cases they appear to be an option of first choice rather than a last resort, when people who are living with dementia are demonstrating challenging behaviours.

"Unnecessarily medicating vulnerable people in care is a profound human rights issue which must be addressed."

In 2009, a report by Professor Sube Banerjee on the use of antipsychotic medication for people with dementia found that antipsychotics appeared to be used too often, with any potential benefits outweighing the risks.

"It is extremely worrying that nearly 10 years after the publication of Professor Banerjee's report there still remain significant concerns about the inappropriate use of antipsychotics in care home settings," added Dr Lloyd.

The committee has called on the Welsh Government to ensure that all health boards are collecting and publishing standardised data on the use of antipsychotic medication in care homes and report back to it on progress within 12 months.

It also wants to make sure all health boards are fully compliant with NICE guidelines on dementia, which advise against the use of any antipsychotics unless the dementia patient is severely distressed or there is an immediate risk of harm to themselves or others.

"A person living with dementia presenting challenging behaviour often has an unmet need which they may be unable to communicate," added Dr Lloyd.

"As such, we believe it is vitally important to look at the person as a whole in order to understand what may be causing a particular behaviour.

"We know that there are various good practice checklists that could be used by staff in care homes to identify the possible causes behind an individual's behaviour.

"Yet we were told that antipsychotics are being used as a default position when people with dementia are difficult to deal with. We believe changes are needed to ensure antipsychotic medications are prescribed appropriately." In response, a Welsh Government spokesman said: "The use of antipsychotic medicines should be in accordance with NICE guidelines, reserved for challenging behaviour of dementia only where the benefits outweigh the risk, and when nonpharmacological approaches have been unsuccessful.

"We welcome the Assembly Committee's report and will now consider its findings."


<'Antipsychotic drugs are increasingly being used to 'manage' challenging behaviour of people with dementia, a new report finds
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Publication:Western Mail (Cardiff, Wales)
Date:May 17, 2018
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