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.

The Banerjee report sets the standard that all people with dementia should have their medication reviewed to ensure their treatment is safe and in line with current best practice.  Experience nationally and locally has demonstrated that it is not as simple as just stopping prescribing – a thorough review is often required to identify and address the causes of distress and challenging behaviour. The dose of antipsychotic may need to be reduced over time with close monitoring and support given to carers/relatives.

Locally, Sussex Partnership NHS Foundation Trust has commissioned a Care Home Dementia In Reach Team to work with GPs and Care Homes to review and, where appropriate, reduce the prescribing of anti-psychotics medication in a supported manner.  Comprehensive guidance and tools have been developed as part of this initiative including promoting alternative strategies for managing challenging behaviour.

This project will commission Antipsychotic Prescribing Support Pharmacists as a specialist resource to:

• Identify the number of people living at home who are currently being prescribed an antipsychotic medication for dementia. This will help establish and confirm local practice level baseline data
• As part of a multidisciplinary team, review those people who are receiving an antipsychotic as part of their dementia treatment.
• Develop resources for clinicians and carers and promote their use to support embedding of good practice to ensure sustainability of the initiative and promoted changes.
• Support local training programmes.
• Link to the Care Home In-Reach team to ensure local services work together for the benefit of people with dementia and their careers.

Objectives

• To improve the overall quality of life for the person with dementia.
• To improve the overall quality of life for the carer or family member.
• To reduce the number of unscheduled admissions for people with dementia.
• To raise awareness of potential risks of inappropriate use of antipsychotic medication.
• To embed good practice in antipsychotic medication prescribing across the Crawley and Horsham and Mid Sussex CCGs
• To enable systematic review of antipsychotic medication at practice level.

Anticipated outcomes

• Reduce the number of people inappropriately prescribed antipsychotic medication.
• Minimise the co-morbid risks of inappropriately prescribed medication – ie stroke, falls.Regular review of antipsychotic medication will ensure that people with dementia are not unnecessarily exposed to the potential side effects of the medication
• GP training will ensure that primary care professionals have the skills to spot inappropriate prescribing and act accordingly.
• A reduction in unscheduled admissions caused by the potential side effects of antipsychotic medication, ie strokes, falls.