'Chemical cosh' rockets in nursing homes

12.00.00am GMT Thu 13th Mar 2003

Commenting on the new research published today in the BMJ that shows the over prescribing of antipsychotics has rocketed by 28% since the last major study, Paul Burstow MP Liberal Democrat Spokesman for Older People said:

"Over medication can cause premature death, and it can deny people their dignity, turning them into zombies. With serious shortages of investment and little chance of attracting more, nursing homes are turning to the chemical cosh to make residents easier to manage.

"Successive Governments have failed to tackle this abuse of vulnerable elderly people. When I first raised this issue after Labour came to power in 1997 the Health Secretary simply dismissed the problems as being a matter for individual GPs. This is simply not good enough.

"The Government has made all the right noises but has spectacularly failed to look into a problem that is blighting the lives of thousands of older people and their families.

"Ministers have been aware of the growing evidence of inappropriate and unnecessary prescribing of anti-psychotic drugs for over six years. The Government has failed to heed the warnings and take the action that would save lives and improve the quality of life for thousands of vulnerable older people."

ENDS

Notes to editors

In December 2001, Mr Burstow produced the report 'Keep Taking the Medicine?' that found up to 35,000 people in nursing homes and 53,500 in residential homes were inappropriately prescribed antipsychotic medication. In the report, Mr Burstow produced a 7-point plan to stem the tide of overmedication:-

- The National Institute for Clinical Excellence must prepare and publish guidance on the use of antipsychotic drugs and non-drug alternatives in the care of older people. This would include the development of a model for drug list revisions in care homes, to automatically evaluate drug lists according to a quality indicator, and keep track of the drug lists and changes made to that list. The quality indicator should also serve as guidelines for prescribers.

- Review the National Service Framework and National Minimum Standards for care homes to ensure that the standard on medication, (standard 9), provides for prescribing reviews at least every three months. All prescribing decisions must be clearly documented with the reasons for the use of the medication set out in full. By evaluating the Scottish legislation which gives the power of attorney to make decisions on medical decisions, the standard should also be reviewed to include a requirement that protocols are developed to ensure the recipient of the drug, or a person with power of attorney, gives informed consent, and that carers are consulted on the use of drugs in care homes.

- Revise the National Minimum Standards target for training care staff, (standard 28) from 50% to 75% of care workers in residential settings by 2005 and 90% by 2007 to NVQ level II. The Department of Health must urgently commission work to review the level of pay and conditions necessary to encourage recruitment and retention.

- The Department of Health should launch an awareness campaign targeting General Practitioners, healthcare staff, psycho-geriatricians, community pharmacists and care staff to alert them to the potential risks and effects of antipsychotic medication. This should also include a review of the information provided to all care staff concerning the use of antipsychotic medication and their side effects and benefits.

- The Department of Health should provide the appropriate training and guidance to enable an increased role for community pharmacists and specialist nurses in the review of medication for older people.

- The Department of Health must urgently examine the adequacy of current care home fee levels of state funded residents to ensure that care homes can provide appropriate levels of care staff.

• In February 2002 a debate was called by Mr Burstow in the House of Commons on abuse of the elderly. In her response, the Minister responsible Hazel Blears MP said:-

"It is possible that the prescription of atypical antipsychotic drugs has increased because care for older people is catching up with trends in care for younger people, where there is an increasing use of modern drugs that have fewer side effects and are more beneficial. However, I do not think that that is the full explanation. The request for research is important."

Since that time, Ministers have failed to commission new research.

• The article can be found at:-

http://press.psprings.co.uk/bmj/march/gp580.pdf