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Friday, September 14, 2012

The other drug problem

A study found almost half of elderly people may be kept on sedatives that make them “easier and more convenient to manage” for much longer than necessary. Research has shown people with dementia who take these drugs are at a much higher risk of stroke.

The report by Dundee University and NHS Fife, carried out over a two-year ­period in Tayside, found two in five elderly people in care homes were taking the drugs – compared to just one in six who still lived in their homes in the ­community. It also found that seven in ten people who were taking the drugs when they went into the care homes were then never reassessed to see if they still needed them.

Dr Colin McCowan, deputy director of the Health Informatics Centre at Dundee University, and one of the authors of the report, said: “Some elderly people are taking these drugs to make it easier and more convenient for people to manage them and for them to cope. Often this could start when they are living at home, on their own, and when they are waiting to go into residential care. But then, when they go into care many are kept on them and remain on them. No-one checks to see if they still need them. Some of these individuals and their families will know about them taking them, but there is evidence some won’t." He said the use of the drugs, known as psychotropic medication, which includes anti-psychotics, was a growing concern to health officials. Dr McCowan said guidelines for the use of the medication stated they should not be used, in most cases, for more than six months. He also said previous research had shown many of the anti-psychotics being prescribed to patients were likely to be having “very little beneficial effect” and could usually be gradually stopped without side effects.

Dr Donald Lyons, chief executive officer of  Mental Welfare Commission for Scotland – an independent body set up to safeguard the interests of people considered to be mentally disordered, said: “Anti-psychotic drugs are unquestionably being overused, more so in care homes but also, to a lesser extent in hospitals. The bottom line is more needs to be done to reduce the number of these drugs being prescribed. The rates are too high...At the end of the day, patients should only ever get any drug if it is for the benefit of their health, not for any other reason, not least to keep them more manageable."
The commission said providing more adequate outside space and stimulating environments were some of the ways to help people cope. Dr Lyons added: “Yes, this costs money, money to pay for the right environment and additional care but surely that is money well spent in the long run."

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