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30 October 2022

Improved prescribing for older people

South London and Maudsley NHS Foundation Trust have launched a tool to improve prescribing for older people.

medley of medication

South London and Maudsley NHS Foundation Trust have launched a tool to improve prescribing for older people.

Medichec is an innovative online tool that helps clinicians identify medicines that could cause memory and cognitive problems in older people.

Medicines known as anticholinergics are prescribed for a range of conditions including urinary incontinence, pain and depression. These drugs block the action of the neurotransmitter acetylcholine, and when this happens in the brain there is an increased risk of cognitive decline and dementia, particularly in older people.

Medichec allows clinicians to easily identify which medicines have an effect on cognition, along with the size of the effect for different medicines individually and in combination. This helps to better inform the choice of medicines.

Justin Sauer, Consultant Psychiatrist at the Memory Service at South London and Maudsley NHS Foundation Trust, said:

“We’ve had lots of interest from other healthcare organisations in the anticholinergic effect on cognition (AEC) scale used at South London and Maudsley NHS Foundation Trust and we wanted to make it easier to access the scale by developing an online tool. Medichec means that medication reviews can happen quickly and more accurately. Healthcare professionals will very quickly get a sense of which drugs could be contributing to a patient’s memory problems or delirium. Where possible, these drugs can then be changed or discontinued. We hope this contributes to safer prescribing for older patients.”

Professor Robert Stewart, Professor of Psychiatric Epidemiology & Clinical Informatics and Co-Chair at the CTI, added:

“Increasing information is now available on medications and their side-effects in people with dementia, and we expect that work on our CRIS health records database will accelerate this process. We set up the CTI to promote faster development of digital interventions and in this respect, Medichec provides the opportunity to feed information on medication in dementia rapidly back to clinicians, patients and carers so that people have better-informed discussions about their healthcare.”

The development of this resource was part-funded by the National Institute of Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King’s College London.

Find out more on the Medichec website.