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Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

Abstract

Objectives

To assess the 2009 National Dementia Strategy's (NDS) impact on dementia diagnosis and treatment.

Setting and participants

Primary care data for England before and after launch of the NDS.

Primary outcome measures

We used nationally available data to estimate the trends over time in rates of dementia diagnoses recorded on the Quality Outcomes Framework (QOF) in Primary Care Trusts (PCT) and antidementia medication prescriptions from 2006/2007 (the first available figures) and the associated increase in cost relative to all other prescriptions. To establish PCT general practitioner (GP) QOF dementia recording validity, we correlated it with medication prescription using the NIC (net ingredient cost).

Results

Regression analysis showed that dementia diagnosis rate was lower prior to launch of the NDS and increased significantly after it was launched. The number of antidementia prescriptions and the cost of antidementia drugs relative to total PCT prescribing costs increased significantly after 2009. GP recording of dementia diagnosis correlated highly with prescription of cholinesterase inhibitors and memantine in the same area (p<0.001 each year).

Conclusions

The launch of the NDS was associated with a significant increase in dementia diagnosis rates and prescriptions of antidementia drugs. We cannot establish the causality but this was a change from the prelaunch pattern. Further assessment of any intervention to increase the diagnoses should include an assessment of harm as well as potential benefit.

Details

Title
Diagnostic rates and treatment of dementia before and after launch of a national dementia policy: an observational study using English national databases
Author
Mukadam, Naaheed; Livingston, Gill; Rantell, Khadija; Rickman, Sam
Publication year
2014
Publication date
2014
Publisher
BMJ Publishing Group LTD
e-ISSN
20446055
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
1785332539
Copyright
Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions