DI-038 Appropriate use of anti-dementia drugs in the elderly: prescription practice evaluation in nursing homes. (24th March 2015)

• Record Type: Journal Article
• Authors: Quillet, P; Mongaret, C; Bonnet, M; Legrand, M
• Is Part Of: European journal of hospital pharmacy. Volume 22(2015)Supplement 1
• Page Start: A89
• Page End: A89
• Publication Date: 2015-03-24
• Subjects: Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2015-000639.214
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Background: Anti-dementia drugs (ADDs), including cholinesterase inhibitors and memantine, are used to improve cognitive function in patients with Alzheimer's disease. However, the literature analysis shows only short-term efficiency of these drugs, with questionable clinical relevance and risk of drug interactions increased by polypharmacy. Purpose: To investigate the prescription practice of ADDs and assess the appropriateness of these medicines in nursing homes. Material and methods: A prospective study was carried out over 60 days, based on all prescriptions received in the pharmacy from 3 nursing homes. Each prescription was analysed and patient records were consulted. Results: Of the 416 patients, 145 were treated with at least one ADD. The stage of the disease was: 11% mild, 26% moderate, 36% moderately severe, 27% severe. 75 patients (52%), including 3 at the mild stage, were receiving memantine monotherapy, marketed for moderate-to-severe stages. 41 patients (28%), including 3 at the severe stage, were receiving anticholinesterase drug monotherapy, marketed for mild-to-moderately severe stages. 29 patients (20%) were taking two drugs, memantine + anticholinesterase, including 3 at the mild and 4 at the severe stage. The treatment had been introduced more than 12 months ago for 114 patients, usually without clinical reassessment. It was often associated with benzodiazepines (n = 63), sometimes with antipsychotic (n = 7) or atropinic drugs (n = 4). Conclusion: The choice of ADD was appropriate for 91% of patients, but the treatment is rarely reassessed and in almost half of cases was associated with a drug known to cause acute cognitive impairment. This study will help us to develop a cross-functional approach between physicians and pharmacists to improve the prescribing of ADDs in nursing homes. References and/or acknowledgements: No conflict of interest.