Black and Asian patients with dementia in the UK receive a worse quality of care than white patients due to differences in prescribing, according to a new study.
Research led by University College London found Asian people with dementia are 14% less likely to receive anti-dementia drugs, cholinesterase inhibitors or memantine – and take them for 15 fewer days per year– than white patients.
Meanwhile, black patients who are prescribed antipsychotic drugs that treat dementia-related distress take them for about four weeks longer than white people in the UK – exceeding suggested limits.
The study, which looked at the records of 53,000 people with a dementia diagnosis in the UK, suggested socioeconomic disadvantage, language and culture differences are to blame in preventing minority ethnic patients from accessing care.
The findings, published in Clinical Epidemiology, showedwhile both black and Asian patients ended up being prescribed antipsychotic drugs for longer than white patients, there were no differences in rates of initial prescription.
This suggests there are differences in medication being reviewed – and stopped – when no longer needed.
The findings follow previous studies in the US and Australia, which have also found disparities in treatment for minority ethnic groups.
‘Potentially significant inequality’
Dr Mary Elizabeth Jones, first author of the study, said: ‘While we have yet to find out whether taking antipsychotic drugs for a few weeks more increases the associated risks – which can include falls, cognitive decline, strokes and even death – it’s a potentially significant inequality which we should take seriously.
‘More work may need to be done to ensure that guidelines are being consistently met and that dementia services are culturally competent.’
Professor Claudia Cooper, lead author of the study, added: ‘While there has been a very sharp reduction in antipsychotic prescribing in the UK over the past 10 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.’
A previous study led by Professor Cooper found that dementia rates are higher among black people, compared with the UK average, and that ethnic minority groups may be less likely to be diagnosed in a timely manner.