Dementia care ‘needs improvement’
MedWire News: Some patients with dementia are still not undergoing the annual dementia review outlined in QOF guidelines, report researchers in the British Journal of General Practice.
Although their study showed that the annual review was completed for the majority (80%) of patients, less than two-thirds of reviews had any record of discussion with patients, and only half included a review of social care.
The findings come from an analysis of primary care records of 994 patients on dementia registers from 52 practices in Greater Manchester. Patients were aged 82 years on average and had had dementia for about 3 years.
GPs completed reviews in 44% of the patients, compared with 26% for psychiatrists and 4% for other health professionals.
Other findings were that 26% of patients were receiving prescriptions for antipsychotic medications, with hallucinations or delusions the reason for prescription in 27% of these. Only half had undergone a review of their medication in the previous 6 months.
"Despite the high prevalence of vascular comorbidity, prescription of antipsychotic medications was common and monitoring inadequate," note the authors, led by Dr Nitin Purandare (University of Manchester).
By scoring practices according to the proportion of relevant reviews provided for eligible patients, the team found that GPs conducted 62% of relevant reviews, but this varied considerably among practices.
"The quality of care score in developed in this study may be useful to commissioners and regulators as a quality marker in performance management," they note.
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By Caroline Price