Call for data on antipsychotic use in Welsh care homes

Sarah Rochira says robust information is needed to determine the true scale of the issue

Data on the use of antipsychotic medication in care homes should be collected to monitor inappropriate prescribing, it has been claimed.

Older People's Commissioner for Wales Sarah Rochira said the use of drugs to manage "challenging behaviour" in dementia patients was "totally unacceptable".

She said robust data was needed to determine the true scale of the issue.

She raised the matter at the assembly's health committee inquiry on Thursday.

In written evidence, Ms Rochira said a "national mechanism" for the collection of prescribing data for antipsychotic medication in care homes should be developed and implemented by the Welsh Government and published annually.

Ms Rochira said: "A range of evidence published in recent years has suggested that antipsychotic medication is being inappropriately prescribed to people living with dementia in care homes to manage so-called 'challenging behaviour', despite the fact that other, non-pharmaceutical interventions would deliver far better outcomes for individuals and have a positive impact upon their quality of life."

She said one study had found "up to four out of five older people living with dementia, who were being prescribed antipsychotics, were gaining no benefit from them".

"Whilst there is growing recognition of this issue across health and social care, including the independent sector, it is vital that robust data is collected to determine the true scale of this issue in Wales so that appropriate action can be taken to prevent older people living with dementia being inappropriately prescribed these powerful and sedating drugs," she added.

The Alzheimer's Society told the health committee's inquiry that to improve understanding of the issue, the Welsh Government should start audits of prescribing antipsychotics in care homes to patients with dementia to improve clinical practice.

It called for ending routine prescribing and a reduction in the time and dosage where antipsychotics are required.

Antipsychotic drugs are primarily used to treat conditions such as schizophrenia and bipolar disorder.

A survey in November 2016 by the Royal College of Psychiatrists found nearly one in five - 18% - of dementia patients were being prescribed them.