10 key steps

Review prescribing

Work with pharmacists, primary, community, and secondary care providers to improve prescribing of anti-dementia drugs and antipsychotics.

DRIVER: Appropriate prescribing of anti-dementia drugs

Actions

Resources

Examples

Audit prescribing of acetylcholinesterase inhibitors. Check for:

adherence to NICE guidance
diagnosis captured on GP dementia register (QOF DEM1)

Collaborative dementia care in Oxfordshire
This project aims to develop a more user-friendly care pathway for people living with dementia in Oxfordshire by providing easier access to assessment for early diagnosis and support within primary care settings. Read more »
Prescribing guidelines: Acetyl Cholinesterase inhibitors
These prescribing guidelines developed by Berkshire Healthcare NHS Foundation Trust support GPs on the use of Acetyl Cholinesterase inhibitors (ChEIs) for the treatment of Alzheimer’s dementia in accordance with NICE guidance. Read more »
Prescribing review: Acetyl Cholinesterase inhibitors
This audit was undertaken by North Staffordshire Combined Healthcare NHS Trust to establish compliance with NICE Technology Appraisal Guidance 111 on the use of donepezil, galantamine and rivastigmine for the treatment of mild to moderately severe Alzheimer’s disease. Read more »

DRIVER: Appropriate prescribing of antipsychotics

Actions	Resources	Examples
Audit prescribing of antipsychotics of adults. Check for: adherence to NICE guidance outliers, where action is needed diagnosis captured on GP dementia register (QOF DEM1)	Audit tool: GP prescribing of antipsychotics to people with dementia Care of dying adults in the last days of life Fix dementia care – NHS and care homes Low expectations Managing behavioural and psychological disturbance in dementia Psychotropic medicine management for people in care homes with dementia Reducing the inappropriate prescribing of antipsychotic medication for people with dementia Resources to support the reduction of inappropriate prescribing of antipsychotics The Right Prescription on-line community The Right Prescription: a call to action on the use of antipsychotic drugs for people with dementia	Accelerating Dementia Diagnosis 2012 action plan This plan sets out actions to accelerate dementia diagnosis across Cornwall and the Isles of Scilly. Read more » Audit of antipsychotic therapy in dementia patients in Hampshire This audit of antipsychotic therapy in patients with dementia was undertaken by NHS Hampshire to ensure it is safe and complies with local guidance. Read more » Medicines optimisation in East Berkshire care homes This project aims to reduce the prescription of antipsychotic medication for people living with dementia in care homes across Windsor, Ascot and Maidenhead. Read more » Reducing inappropriate antipsychotic prescribing in Sussex This project aims to commission Antipsychotic Prescribing Support Pharmacists to review and, where appropriate, reduce the prescribing of anti-psychotics medication in a supported manner for people living with dementia in Sussex. Read more » Training programme to reduce antipsychotic prescriptions in care homes An Alzheimer’s Society training programme is being rolled out to 150 care homes across the UK to increase understanding and awareness of dementia and provide tools, ideas and resources to enable staff to provide good quality person-centred care. Read more »
Review regularly general practice patients living in care homes who have been prescribed antipsychotics.	Care of dying adults in the last days of life Fix dementia care – NHS and care homes Low expectations Psychotropic medicine management for people in care homes with dementia The Right Prescription: resource pack	Medicines optimisation in East Berkshire care homes This project aims to reduce the prescription of antipsychotic medication for people living with dementia in care homes across Windsor, Ascot and Maidenhead. Read more » Reducing inappropriate antipsychotic prescribing in Sussex This project aims to commission Antipsychotic Prescribing Support Pharmacists to review and, where appropriate, reduce the prescribing of anti-psychotics medication in a supported manner for people living with dementia in Sussex. Read more » Training programme to reduce antipsychotic prescriptions in care homes An Alzheimer’s Society training programme is being rolled out to 150 care homes across the UK to increase understanding and awareness of dementia and provide tools, ideas and resources to enable staff to provide good quality person-centred care. Read more »
Consider training needs of care home staff in the management of behavioural symptoms.
Engage with care home management and pharmacy leads to address this, where appropriate.

Dementia Partnerships

Sharing knowledge and learning across the Well Pathway for Dementia

10. Review prescribing

10 key steps

Review prescribing