CCU016: Cardiovascular and cerebrovascular diseases related to antipsychotic prescribing in patients with dementia during the COVID-19 pandemic

Project lead:
Tim Wilkinson, University of Edinburgh

People living with dementia have been amongst the hardest hit during the COVID-19 pandemic. A group of drugs called ‘antipsychotics’ are sometimes used to treat distress and agitation in people living with dementia. However, there is evidence to suggest that these medicines may increase the risk of stroke and heart attacks when given to people with dementia. They should therefore only be used as a last resort, when other treatments have failed.

Since March 2020, the prescribing of these drugs for people with dementia has increased. We think this may be because social distancing restrictions have caused more people to need treatment for distress or agitation as they do not have access to their normal support structures. This increase in antipsychotic prescribing during the COVID-19 pandemic is concerning, as it may have led to an increase in heart attacks and strokes in these patients.

We will investigate whether this increase in antipsychotic prescribing has led to an increase in strokes or heart attacks. To do this, we will use information that is collected routinely by health services, such as GP records, prescriptions and diagnoses recorded in hospital. We hope that the results of this study will help inform decision making between doctors, patients and carers, by enabling them to weigh up the risks and benefits of prescribing an antipsychotic.

Outputs

Antipsychotic drug prescribing and mortality in people with dementia before and during the COVID-19 pandemic: a retrospective cohort study in Wales, UK

  • The Lancet Healthy Longevity publication 03/08/23 can be viewed here
  • medRxiv preprint 19/02/23 can be viewed here
  • Code and phenotypes used to produce this paper are available in GitHub here

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