A study has found that medication for Alzheimer patients is being cut by doctors, far too early. The medication costs just 6p a day and could keep tens of thousands of Alzheimer patients out of care homes across the country.
Donepezil is prescribed for people with mild to moderate dementia but is stopped in later stages of the disease because doctors believe it’s of little use.
However, a recent study has suggested that the drug can keep brain cells firing and allows sufferers with later stages to continue with day to day living such as eating, dressing and going shopping. For up to 12 months after they’ve been admitted to a care home.
It’s estimated by researchers at University College London that 26,000 people a year could stay at home longer if their doctors kept them on Donepezil.
Also known as Aricept, the drug costs £21.59 a year, while care homes can cost up to £34,000 a year. Not only is it better for people’s health to stay in the comfort of their own home but this could also be a huge saving for the NHS, which is much needed.
Dementia charities and other health experts said it is ‘crucial’ that the NHS make best use of the drug until a cure is found.
“It’s a moderate effect but it’s important if it’s your mother or your wife or someone close to you,” said lead author Robert Howard, Professor of Old Age Psychiatry at UCL.
“Our new results show that these benefits translate into a delay in becoming dependent on residential care, an event that many people dread.
“The drug is available very cheaply, and it’s available now, so it’s something that could have a benefit now.”
Donepezil works by improving the neurotransmitter acetylocholine which keeps neurons firing correctly and increases brain power. Although it doesn’t stop the development of Alzheimer’s it does lessen the symptoms so that people find daily tasks more manageable.
Originally it was licenced for mild and moderate dementia, but the health spending watchdog, the National Institute for Health and Care Excellence (Nice), has since told doctors they are free to continue prescribing, after a trial in 2012 showed it provided cognitive and functional benefits in later stages.
Although GPs have been given permission to continue prescriptions, many continue to stop the drug earlier as they feel the benefits don’t outweigh the side-effects which come with the medications. Some of these side effects include nausea and heart arrhythmia.
The recent trial, printed in The Lancet Neurology, tracked 295 people who had been enrolled on the original 2012 study to see how well they did after doctors returned to normal prescribing. Over a third of people who were taken off Donepezil ended up in a care home within 12 months, compared with just a fifth of those who remained on the drug.
Dr Ian Maidment, Senior Lecturer in Clinical Pharmacy at Aston University, and spokesperson for the Royal Pharmaceutical Society said doctors should think twice about withdrawing Donepezil if a patient is managing at home.
Most people with dementia and their carers want to live at home for as long as possible,” he said.
“Stopping Donepezil could worsen the ability of the person with dementia to cope with the usual activities of daily living which may mean that living at home becomes impossible.”
It’s believed that roughly 570,000 people are currently suffering with Alzheimer’s disease in the UK alone, which is the most common form of dementia. Around only 58,600 are taking Donepezil, but many more sufferers would benefit from it.
Dr Doug Brown, Director of Research and Development at Alzheimer’s Society said the findings were ‘of real significance’ to people with dementia and their families.
“With no new treatments for Alzheimer’s disease in over a decade it is absolutely crucial that we make the most of the drugs that we have available,” he said.
“It is important that we continue to find better ways to support people with dementia to remain in their own homes for longer. We urge clinicians to consider the implications of this research and adjust their prescribing patterns accordingly.
In the last few years it’s been a growing concern in the healthcare industry that not only are dementia sufferers miss treated in care homes but also quickly decline once admitted.
In 2014 the Care Quality Commission warned that all dementia sufferers where likely to be rushed, treated impersonally or have uncaring treatment at some point during being at a care home. The assessment of standards followed a special programme of inspections focusing on standards of care for people with dementia.
Dr Elizabeth Coulthard, Consultant Senior Lecturer in Dementia Neurology, University of Bristol, said it was ‘heartening’ to think that Donepezil could delay entry to nursing homes.
“This is potentially good news for people with Alzheimer’s and their families.
“When multiplied across the large numbers with dementia, even small reductions in care needs for an individual could result in significant cost savings overall.”
Dr Kathryn Adcock, Head of Neurosciences and Mental Health at the Medical Research Council, added: “This study provides strong evidence that donepezil can benefit people in the more severe stages of Alzheimer’s disease for longer than was expected.
“The number of people with dementia is at a critical level and it’s never been more important to invest in research to help doctors make informed decisions about treatments for their patients.
“We currently have no cure for dementia but we are closing the gap and in the meantime, we are committed to developing effective and safe treatments to improve the quality of life for people with Alzheimer’s disease and their caregivers.”
- May 2021