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dc.contributor.authorDonegan, K
dc.contributor.authorFox, N
dc.contributor.authorBlack, N
dc.contributor.authorLivingston, G
dc.contributor.authorBanerjee, S
dc.contributor.authorBurns, A
dc.date.accessioned2020-05-12T09:14:30Z
dc.date.available2020-05-12T09:14:30Z
dc.date.issued2017-03
dc.identifier.issn2468-2667
dc.identifier.issn2468-2667
dc.identifier.urihttp://hdl.handle.net/10026.1/15663
dc.description.abstract

BACKGROUND: The objectives of this study were to describe changes in the proportion of people diagnosed with dementia and the pharmacological treatments prescribed to them over a 10 year period from 2005 to 2015 at a time of UK policy strategies and prioritisation of dementia. We aimed to explore the potential impact of policy on dementia care. METHODS: In this longitudinal retrospective cohort study, we included all patients registered at a Clinical Practice Research Datalink (CPRD) practice between July 1, 2005, and June 30, 2015, with a diagnosis of dementia defined using Read codes. The main outcomes were the number and proportion of acceptable patients, who met the CPRD threshold for data quality, in a GP practice defined by the CPRD as contributing up-to-standard data with a diagnosis of dementia and the number and proportion of these with a prescription for an antidementia or antipsychotic medication. We examined the prevalence of dementia diagnosis and prescribing by calendar quarter, and stratified by age, sex, and UK country (England, Scotland, Wales, or Northern Ireland). We investigated the use of antidementia drugs, alone and in combination, antipsychotics, antidepressants, anxiolytics, and hypnotics. The trend in the proportion of patients with a diagnosis of dementia, before and after the introduction of the UK National Dementia Strategy, was estimated using an interrupted time-series analysis. FINDINGS: 8 966 224 patients were identified in the CPRD whose most recent registration period overlapped the study period. Of these, 128 249 (1·4%) had a diagnosis of dementia before the end of the study period. The proportion of people diagnosed with dementia in the UK doubled from 0·42% (19 635 of 4 640 290 participants) in 2005 to 0·82% (25 925 of 3 159 754 participants) in 2015 (χ2 test for trend, p<0·0001), and the proportion of those who received antidementia medication increased from 15·0% (2942 of 19 635) to 36·3% (9406 of 25 925). The interrupted time-series analysis showed a significant acceleration in the rate of diagnosis of dementia after the introduction of the UK National Dementia Strategy (p<0·0001). There was a large reduction in antipsychotic drug prescription in dementia from 22·1% (4347 of 19 635) in 2005 to 11·4% (2943 of 25 925) by 2015. INTERPRETATION: Over the 10 years studied, there is evidence of a sustained positive change in diagnosis rates of dementia and in the quality of drug treatment provided to those diagnosed. The prescription of antidementia drugs more than doubled and the prescription of potentially hazardous antipsychotics halved after the introduction of national dementia strategies. These data support the formulation and delivery of national policy to improve the quality of care for people with dementia. FUNDING: None.

dc.format.extente149-e156
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoeng
dc.publisherElsevier BV
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAntipsychotic Agents
dc.subjectDementia
dc.subjectDrug Prescriptions
dc.subjectFemale
dc.subjectHealth Policy
dc.subjectHealth Priorities
dc.subjectHumans
dc.subjectLongitudinal Studies
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRetrospective Studies
dc.subjectUnited Kingdom
dc.titleTrends in diagnosis and treatment for people with dementia in the UK from 2005 to 2015: a longitudinal retrospective cohort study
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/29253388
plymouth.issue3
plymouth.volume2
plymouth.publisher-urlhttp://dx.doi.org/10.1016/s2468-2667(17)30031-2
plymouth.publication-statusPublished
plymouth.journalThe Lancet Public Health
dc.identifier.doi10.1016/s2468-2667(17)30031-2
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School/PMS - Manual
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeEngland
dcterms.dateAccepted2017-01-11
dc.identifier.eissn2468-2667
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/s2468-2667(17)30031-2
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-03
rioxxterms.typeJournal Article/Review


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