6p a day drug could keep elderly out of care homes
A DRUG which costs 6p a day could keep tens of thousands of Alzheimer’s patients out of care homes, but doctors are stopping medication too early, a study has found.
Donepezil is prescribed for people with mild to moderate dementia but is withdrawn in the later stages of the disease because GPs believe that it does little good.
But a new study suggests that the drug, which is also marketed under the brand name Aricept, can keep brain cells firing and allow people with latestage dementia to continue to dress, eat and go shopping for at least 12 months after they would have been admitted to a home.
Researchers at University College London estimate that 26,000 people a year could stay in their own homes if doctors kept prescribing donepezil.
The drug costs £21.59 a year, while care homes can cost up to £34,000 annually, so allowing patients to remain on the medication could also mean a huge saving for the NHS.
Health experts and dementia charities said it was crucial that the NHS made best use of the drugs it had until a cure for Alzheimer’s was found.
“It’s a moderate effect but it’s important if it’s your mother or your wife or someone close to you,” said the lead
author, Robert Howard, professor of old age psychiatry at UCL. “Our results show 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.”
Dr Doug Brown, of the 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 we make the most of the drugs 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.”
Donepezil works by boosting the neurotransmitter acetylocholine, which keeps neurons firing correctly and boosts brain power. Although it does not halt the progression of Alzheimer’s, it alleviates the symptoms so that people find daily tasks more manageable.
Originally it was licenced for only mild and moderate dementia, but the health spending watchdog, the National Institute for Health and Care Excellence, told doctors they were free to continue prescribing after a trial in 2012 showed it provided cognitive and functional benefits in later stages.
However, many GPs still stop the drug early in the belief that the benefits do not outweigh the side-effects which can include nausea, and in some cases heart arrhythmia. The new trial, published in The Lan
cet Neurology, followed 295 people who had been enrolled on the 2012 study to see how well they did after returning to normal prescribing. It found 37 per cent of people who were taken off donepezil ended up in a care home within 12 months, compared with 20 per cent of those who remained on the drug.
Dr Ian Maidment, spokesman for the Royal Pharmaceutical Society, said doctors should think twice about withdrawing donepezil if a patient was managing at home.