Prescribing anti-dementia drugs to patients could help delay their
admission to care homes,
according to a
new study published in the October issue of
The
Psychiatrist.
Psychiatrists Dr Emad Salib and Dr Jessica
Thompson studied a total of 339 people with dementia, who were
referred to psychiatric services in Peasley Cross Hospital in St
Helens in 2006.
127 of the patients (24%) had been prescribed
cholinesterase inhibitors. These drugs can help slow the
progression of the disease by preventing an enzyme known as
acetylcholinesterase from breaking down acetylcholine in the brain.
Of the patients who were prescribed cholinesterase inhibitors,
almost three-quarters (74%) were given donepezil (which is marketed
under the trade name Aricept). A further 14% were given galantamine
(trade name Reminyl), 8% rivastigmine (trade name Exelon), and 4%
memantine (trade name Ebixa).
The remaining 212 patients in the study were
not prescribed cholinesterase inhibitors. After four years, the
researchers followed up all 339 patients to see if they had been
placed in care or remained in their own home.
The researchers found that, on average,
patients who did not take anti-dementia drugs moved to care homes
sooner than patients who did. There was a delay in admission to
care homes by a median of 12 months for patients who took
anti-dementia drugs, compared to those who did not. However, after
three years, an equal proportion of patients from both treatment
groups had been admitted to care homes. In other words, the delay
in admission was relatively short-lived.
Dr Emad Salib, a consultant psychiatrist and
lead author of the research, said: “Our study provides some
evidence to suggest that prescribing cholinesterase inhibitors is
associated with a delay in care home placement in the first 2.5
years of treatment. However, we cannot say whether this association
is causal or if it is the result of a number of different
factors.
“Moving a person to a care home is a
significant and distressing event both for the individual and their
family, and most carers wish to maintain home care for as long as
possible. Any measure that may help to delay institutional care is
invaluable, but we must ensure the evidence is robust. That’s why
we welcome the recommendation by the National Institute for Health
and Clinical Excellence (NICE) for further research in this
area.”
For further information, please
contact:
Liz Leicester
or Deborah Hart in the Communications
Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
References:
Salib E and Thompson J. Use of anti-dementia drugs and delayed care home placement: an observational study. The Psychiatrist 2011; 35: 384-388