 |
18 May 2011
Introduction
In January 2011 the Department of Health released its better practice guide ‘Living well with dementia: A National Dementia Strategy Good Practice Compendium – an assets approach’.1 This good practice compendium has been brought together to support the local delivery of the National Dementia Strategy and improve outcomes for people with dementia and their carers.
There are approximately 820,000 people in the UK (1.3% of UK population) who suffer with dementia, but it affects the lives of many more.2 With an ageing population and improved rate of diagnosis, the number of people with dementia is expected to rise.3
Action
This compendium1 will be useful to everyone involved in supporting people with dementia who use health and social care services within any setting, including community care centres; care homes; primary care; hospitals; patients own homes; or private, voluntary or charitable organisations. Groups of individuals, teams and organisations supporting people with dementia and their carers should review the examples of good practice included in the compendium and use them to improve the care that they give and the services they provide.
Many of the good practice examples included in the compendium focus on key prescribing and medicines management initiatives; such as improving the appropriate use of anti-psychotics, reducing polypharmacy, and increasing clinical medication review. Implementing the learning from these initiatives can help towards achieving the priority objectives of the Quality Outcomes for People with Dementia4, which are:
- good-quality early diagnosis and intervention for all
- improved quality of care in general hospitals
- living well with dementia in care homes
- reduced use of antipsychotic medication
What does this mean to medicines management?
Delivering a higher standard of care to both diagnosed and pre-diagnosed sufferers of dementia needs to be targeted with a full review of how current systems and services operate in different care settings.
Health professionals, NHS commissioners, and service providers should work towards establishing a partnership approach to tackling the problems facing dementia patients and their carers and provide on-going patient-centred care specific to the needs of each individual.
To achieve success at both local and national level the priorities aimed at improving outcomes for patients with dementia and their carers need to be fully understood and acted upon by all staff and services. Increased availability and accessibility of local information to support dementia patients and their families can help this be achieved. Further suggestions that can lead to improvements in dementia care, as mentioned in the compendium, 1 include:
- improved training for staff;
- improved access to services;
- better signposting of dementia services;
- improved choice and control; and
- Improved communication and joint networking between services.
The good practice medicines management initiatives that are included within the guide1 include:
- A uniform approach to prescribing of anti-dementia medications and subsequent monitoring, ensuring consistency of service and fair access to treatment (Pages 19-21)
- Pharmacy involvement at daily reviews (Pages 56 – 58)
- Reducing the use of inappropriate prescribing of medication in care homes for people with dementia (Pages 96-101).
- Improving the prescribing of anti-psychotics (Pages 80-83).
- Improving access to dementia care services to support adherence (Pages 40-45).
- Anti-psychotic medication reviews in care homes (Pages 125-127).
How does this relate to other publications or evidence?
The Department of Health released its first National Dementia Strategy guide ‘Living well with dementia – a national dementia strategy’ in February 2009 and has continued to work with key stakeholders since then to transform dementia services. For a full list of the National Dementia Strategy guides produced by the Department of Health click here.
The NPC MeReC Stop Press (2009) ‘Government takes action on reducing the use of antipsychotic drugs in dementia’ helps to give more insight into the cautious approach that needs to be taken when prescribing medicines to patients with dementia and in particular the risks that are associated with the over prescribing of antipsychotic drugs. Also, the NPC MeReC bulletin on ‘The treatment of Dementia (Volume 18, Number 1; 2007)’ helps to give an in-depth analysis of the condition with an important section in the appendix highlighting ‘what is the evidence for the efficacy of drug treatments in dementia?’
More information to support improvements for dementia patients and carers can be found in the following NPC e-learning topics [Dementia] [Working with groups – building effective networks] [Involving patients and the public] [Effective teamworking] [ Engaging with others] [Multidisciplinary teamworking]
References
- Department of Health (2011). Living well with dementia: A National Dementia Strategy Good Practice Compendium – an assets approach.
- Health Economics Research Centre (2010). Dementia 2010
- Department of Health (2010). Nothing ventured, nothing gained: risk guidance for dementia.
- Department of Health (2010). Quality outcomes for people with dementia: building on the work of the National Dementia Strategy
Please comment on this rapid review in the NPC discussion rooms, or using our feedback form.
Make sure you are signed up to NPC Email updates — the free email alerting system that keeps you up to date with the NPC news and outputs relevant to you