Concerns over racial disparities in dementia treatment

Black and Asian people with dementia in the UK do not receive the same quality of care as white patients with the same condition, a new study claims today.

The research, led by UCL, found that Asian people with dementia are less likely to receive anti-dementia drugs, and will take them for shorter periods, while those from black ethnic groups tend to be prescribed antipsychotic drugs and take them for about four weeks longer per year compared to white people.

Professor Claudia Cooper, of UCL’s Psychiatry department, described the findings, published in the latest edition of Clinical Epidemiology, as “concerning”.

The research team used data from The Health Improvement Network primary care database between 2014 and 2016, analysing 53,718 people with dementia and 1,648,889 people without the condition.

They found that Asian dementia patients were 14% less likely than their white counterparts to be prescribed anti-dementia drugs when they were potentially beneficial – and received them for an average of 15 fewer days per year.

Both black and Asian people with dementia were also found to be prescribed antipsychotic drugs for longer than white patients – 27 and 17 days more, respectively – which puts them at greater risk of suffering harmful side effects.

The data backs up studies carried out in the USA and Australia. These also found disparities in drug treatment for dementia for minority ethnic groups.

The researchers say disparities in prescribing could partly ascribed to greater socioeconomic disadvantages experienced by minority ethnic groups, which lead to barriers to accessing care, as well as language and cultural barriers.

Professor Cooper said: “Our new findings are concerning as they appear to reflect inequalities in the care people receive to treat symptoms associated with dementia.

“Rates of antipsychotic prescribing in all ethnic groups exceeded recommendations for treating the often very distressing behavioural and psychological symptoms of dementia, such as agitation or challenging behaviours, which are the most common reasons antipsychotic drugs are prescribed to people living with dementia.

“While there has been a very sharp reduction in antipsychotic prescribing in the UK over the past ten years, these figures suggest there is still work to do to ensure that people with dementia only receive potentially harmful antipsychotic drugs if there are no acceptable alternatives.”

Jones ME, Petersen I, Walters K et al. Differences in psychotropic drug prescribing between ethnic groups of people with dementia in the United Kingdom. Clinical Epidemiology 20 January 2020.

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