Impact of deprivation, dementia prevalence and regional demography on
prescribing of anti-dementia drugs in England 2009-2019: a time trend
analysis
Abstract
Aim This study aimed to examine trends in prescribing of anti-dementia
drugs in primary care in England between 2009-2019 and to investigate
the impact of deprivation, regional demography and disease prevalence on
prescribing practices. Methods Analysis of publicly available government
data from various sources pertaining to primary care prescribing and
demographics was conducted. All primary care prescription data
pertaining to anti-dementia drugs and antipsychotic drugs in England
between 2009-2019 were extracted and adjusted for inflation and
populations changes. Data across English Clinical Commissioning regions
and groups were compared to explore the association between prescribing
trend, deprivation, regional demography and dementia prevalence.
Anti-psychotic drugs prescribing trends were used as reference
comparators. Results The number of prescription items for anti-dementia
drugs in England increased by approximately three-folds from 24
items/1,000 populations in 2009 to 70.9 items/1,000 populations in 2019;
prescribing of antipsychotics increased by 37.6%. In 2019, the least
deprived areas had approximately twice the rate of prescribing of
anti-dementia drugs compared to the most deprived areas [median (IQR)
values of 46.7 (36.6-64.8) vs 91.23 (76.2-95.1) items/1,000 populations
respectively]. A weak positive correlation (Pearson’s
correlation-coefficient 0.371, p=0.413) was observed between dementia
prevalence and prescribing rates. Conclusions The three-fold rise in the
number of prescription items for anti-dementia drugs in the study period
reflects the policy emphasis on early diagnosis and treatment of
dementia. Higher rates of prescribing in the least deprived areas may be
reflective of higher life expectancy, better diagnoses and access to
treatments. Such differences need to be investigated further.