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National Dementia and Antipsychotic Prescribing Audit

The National Dementia and Antipsychotic Prescribing Audit (DAP) gathers information from GP practices to give a national picture of prescribing antipsychotic medication for people with dementia.

Approximately 750,000 people in the UK live with dementia, and it is estimated that around 25 per cent of these (180,000 people) are currently being prescribed antipsychotic medication designed to treat conditions such as schizophrenia.

For around 36,000 people with dementia, antipsychotic drugs are the right treatment option, but they are often prescribed inappropriately to people with dementia.

The use of antipsychotic medication can lead to serious side affects for people with dementia, so the government has made a commitment to reduce the inappropriate prescribing of this medication.


What does it measure?

The National Dementia and Antipsychotic Prescribing Audit collects demographic and prescribing information on people with dementia from GP practices in England. The audit aims to provide a national picture of prescribing antipsychotic medication in people with dementia.

The data items collected include:

  • NHS number
  • patient date of birth
  • patient sex
  • patient postcode
  • GP practice code
  • diagnosis code
  • diagnosis date
  • prescribed drug (from the specified drug list)
  • prescribed drug start date
  • prescribed drug end date

The NHS number is essential for linking prescribing and complication data and allows the removal of duplicate records.


Benefits

  • provides publicly available information on the current prescribing of antipsychotic medication for people with dementia and their carers
  • supports the government's commitment to reduce the inappropriate prescribing of antipsychotic medication
  • helps GP practices identify where services can be improved.

Who manages the audit?

This audit has been endorsed and is supported by the Royal College of General Practitioners.

In 2010, the Department of Health commissioned the NHS Health and Social Care Information Centre (HSCIC) to carry out an audit to generate data on the use of antipsychotic medication for people with dementia in each primary care trust in England to generate baseline data.

The DAP Audit is supported by the National Clinical Director for Dementia, Alistair Burns and the Royal College of General Practitioners. In addition, the DAP has approval from the National Information Governance Board (NIGB) Ethics and Confidentiality Committee (ECC), formerly Patient Information Advisory Group (PIAG), to collect the data required to conduct the audit.


How is the data collected?

In September 2010 and March 2011, the Health and Social Care Information Centre performed a re-run of the analysis used in a 2009 report to provide the Department of Health with a position update and aid the development of the audit.

In June 2011, the audit focused on a non-patient-identifiable data extract from selected GP practices to provide a picture of antipsychotic prescribing trends, using date of prescription where possible to show trends over a number of years, for people with dementia.

The National Information Governance Board (NIGB) confirmed that due to the anonymised nature of this data, this approach did not require Section 251 approval (external).

The Health and Social Care Information Centre used the data extracted to provide high level patient counts against the prescribed drug over a number of years, from 2006 to 2010, to highlight any trends in the prescribing of antipsychotic medication.

In December 2011, the audit was rolled out nationally to GP practices across England. It used an automated data extract function to reduce the burden of participation.

Organisations and people with dementia can feel confident that participating in the audit is legal and ethical. Written consent from patients is not required to submit their data to the audit.


Audit results

The national summary, PCT level reports can all be accessed from the catalogue. For GP level reports, the following applies:

  • GP level reports will be held securely and only a valid GP will be able to access their report by logging in to https://login.ic.nhs.uk/Register.aspx
  • A user registration from must be completed for reports. This includes full details on how a GP can gain access to their GP level report.
  • The completed form must be submitted to enquiries@hscic.gov.uk by the practice manager from an nhs.net email address to validate the registration.
  • Dissemination sharing of GP reports will be solely at the GPs discretion
  • GP level reports are only available for practices who have submitted data to the audit. 

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