The Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement goals. The framework aims to embed quality within commissioner-provider discussions and to create a culture of continuous quality improvement, with stretching goals agreed in contracts on an [read the full story…]
There is a clear need for specialist assessment and care for older people who self-harm, according to two papers published in the May issue of the British Journal of Psychiatry. Researchers from the University of Manchester studied 1,177 people over the age of 60 who were admitted to six general hospitals in Oxford, Manchester and Derby [read the full story…]
People with Alzheimer’s disease experience a loss of nerve cells that use a chemical called acetylcholine as a chemical messenger. Dementia symptoms become more severe as more nerve cells are lost. Cholinesterase inhibitors are a group of drugs (including donepezil, rivastigmine and galantamine) that prevent the enzyme acetylcholinesterase from breaking down acetylcholine in the brain. [read the full story…]
Regular readers may recall previous blogs where I have written about the dangers associated with antipsychotic drugs in elderly patients. Many of you have responded simply and emotionally on Twitter by saying: “Stop prescribing these drugs!” Others have recognised that the issue is far from clear cut as a fair proportion of patients do have [read the full story…]
Mood, memory and behaviour are all affected by dementia and it is not unusual for behaviour to become ‘challenging’. People with dementia may become agitated or aggressive and this can be extremely difficult and stressful for family members and carers. Challenging behaviour has traditionally been managed with antipsychotic drugs, despite the fact that they do [read the full story…]
This topic has been well publicised in recent years and for good reason. We know that there is a huge disparity between the number of people with dementia who are prescribed antipsychotics (180,000 in England each year) and the number who may derive some benefit from the treatment (36,000). We also know that dangerous side [read the full story…]
Alzheimer’s disease affects 1-2% of people aged 65-70 and approximately 20% of those over 80 years. As our population ages, the condition is on the increase and it’s estimated that 2030, an estimated 7.7 million Americans aged 65 and older will have Alzheimer’s disease. We do not yet know exactly how and why Alzheimer’s disease [read the full story…]
Late-onset schizophrenia is relatively common. Onset after the age of 40 years is reported in 23% of patients hospitalised with schizophrenia. The condition is different from early-onset schizophrenia on a number of counts, including the response to antipsychotic drugs. This Cochrane review set out to assess the effects of antipsychotic drugs for elderly people with [read the full story…]
The Joint Commissioning Panel for Mental Health (JCP-MH) have published the first of their guides aimed at GPs who will soon be commissioning mental health services. Each of the guides provide a description of what a ‘good’ service configuration should look like, and brings together scientific evidence, service user and carer experience, and case studies [read the full story…]
Following on from my post yesterday about screening tools for depression in later life, here is a new meta-analysis that explores the efficacy of antidepressants for the treatment of major depressive disorder (MDD) in patients aged ≥ 55 years. The researchers from the University of Modena and Reggio Emilia in Italy just searched PubMed for [read the full story…]
