The use of NHS databases to identify and manage pharmacotherapy in people with dementia and/or late-life mental disorders

Older people with dementia and mental health disorders frequently have co-occurring acute and chronic conditions resulting in polypharmacy. However, these populations are under-represented in clinical trials, and drug efficacy and tolerability are poorly understood. Electronic health records data represent valuable resources to investigate medication safety. This report outlines the complexity of pharmacotherapy in late life and the key factors that need to be taken into consideration. In relation to the impoverished evidence base to support prescribing, it considers the important potential role of electronic health records data resources in addressing this, particularly within the UK National Health Service (NHS). The different types of current NHS databases in specialist and primary care are discussed alongside research outputs using these resources related to pharmacotherapy in people with dementia and/or late life metal disorders. NHS databases have particular value because of comprehensive catchment-based care provided by mental health and dementia diagnostic services and detailed long-term prescribing data captured in primary care. However, care for these disorders is usually delivered across multiple sectors with differing strengths and limitations in information availability and more work is needed in improving linked data infrastructures.