Feeding tubes in dementia: is there an effective UK strategy?

doi:10.1136/bmj.329.7471.917-b

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D S Sanders (d.s.sanders28@btopenworld.com), consultant gastroenterologist,
Karna D Bardhan, consultant physician

Royal Hallamshire Hospital, Sheffield S10 2JF
Rotherham District General Hospital, Rotherham S60 2UD

EDITOR—In their quality improvement report Monteleoni and Clark showed a reduction in the number of gastrostomy tubes inserted (in patients with dementia) after specific quality interventions had been implemented.1 We would like to add two points to the debate.

Firstly, how applicable is this observation to the United Kingdom? We have previously reported a high mortality in patients with dementia who have a percutaneous endoscopic gastrostomy (PEG) tube inserted.2 As a result …