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Study dispels fears as patients manage anticoagulants safely

GPs have been urged to continue to follow the advice of secondary care clinicians on the prescribing of an Alzheimer's drug, despite an NHS study that found it to be a waste of money.

The five-year study, which was carried out in Birmingham, found that donepezil had little effect on memory and did not stop the progression of disability, despite costing the NHS more than £39 million a year.

The study, published in The Lancet (June 26), questioned whether 'other uses of the scarce resources allocated to dementia care would provide better value than routine prescription of cholinesterase inhibitors'.

NICE guidance states that patients with mild to moderate Alzheimer's disease should be prescribed a cholinesterase

inhibitor by a specialist and that GPs can take over prescribing under a shared-care protocol.

The study, which involved 565 patients, found that donepezil did improve tests of mental and functional ability over the first two years of treatment, although at low levels.

Dr Joe Neary, a GP in Yorkshire with a special interest in elderly people, said the drug, which is initiated in secondary care but monitored by GPs, provided hope to many Alzheimer's sufferers and their families.

He said: 'The difficulty with cost-benefit analysis is the focus on perceived benefits in an averaged-out way which is very difficult to relate to individual experiences.

'Donepezil may "only" defer a person going into residential care by six months or so but that six months can give them extra time with their families and so on.'

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