Background The prevalence of Alzheimer’s disease (AD) reaches up to 20% in Spain’s population over 80 years old. Even though several medicines are available today, there is limited evidence regarding their effectiveness, without forgetting their potential adverse events. Consequently, close therapeutic monitoring is necessary to identify cases in which there are no clear signs of therapeutic benefit.
Purpose To analyse the use of anti-dementia drugs in patients diagnosed with AD with the purpose of optimising it in the future.
Material and methods Retrospective observational study of poly-medicated patients living in nursing homes aged over 75 years, who took part in a medicines reconciliation project during 2013.
Data collection included age, sex, degree of dementia, number of chronic drugs and type of drug to treat AD.
Clinical guidelines were reviewed in order to check recommendations for AD treatment (Cholinesterase Inhibitors (CIs) are recommended in mild-moderate AD, whereas memantine is indicated in severe AD).
Results Eighty four (13.9%) out of 604 patients analysed were being treated with anti-dementia drugs (59.5% females, with an average age of 85.9 years and taking a median of 10.5 drugs daily). Memantine was the most common anti-dementia drug among our patients: 31 patients (36.9%) were taking it, 17 in monotherapy (20.24%), and 14 (16.7%) in association with CIs.
The most frequently used CIs were rivastigmine and donepezil, with 29 (34.52%) and 27 (32.4%) patients respectively. On the other hand, galantamine was prescribed in 12 patients (14.29%). With regard to the degree of dementia, 8 patients with severe dementia weren’t being treated with memantine, whilst 4 with mild dementia were using this drug. Moreover, one case of association of donepezil and rivastigmine was identified.
Conclusion Twelve cases (14.29%) were identified whose treatment did not accord with the clinical guidelines consulted. These findings reflect the need to revise and update treatments, adapting them to the medical condition of patients.
References and/or acknowledgements UpToDate
No conflict of interest.
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