Background and Importance Those elderly, dementia patients who receive treatments for their various chronic diseases belong to a high risk cohort. Their individualised medication should avoid treatment with multiple drugs and with active substances which pose a health risk for them. This may eliminate the adverse effects to which these patients are particularly susceptible.
Aim and Objectives The study evaluates the medical treatment of dementia patients receiving chronic and palliative cares simultaneously. We collected data of individualised medications from historic patient records in 2020–2021. The study was approved by the research ethics committees of the university and the hospital (IG/02176-000/2022)
Materials and Methods We examined the real-world data of drug treatment in dementia patients aged 65 or older who spent at least 5 days in the hospital. We analysed the anonymised, aggregate data. We used international databases compiled from meta-analyses and systematic reviews (Beers Criteria, START/STOPP, WHO, EMA and UCSF).
Results We analysed the drug treatment history of 108 patients (74 women and 34 men with the average age of 80.5 ± 9 year), who met the preliminary selection criteria. We classified the patients into the following cohorts: 1.9% direction diagnosis, 20.4% basis of the main diagnosis, 35.2% main diagnosis, 38.9% comorbidity and 3.7% disease underlying death. The distribution of dementia types were: 53.7% vascular, 1.9% related to other diseases and 44.4% unspecified. The average number of medicines taken per day per patient was 10.8 pieces. Multiple drug treatment occurred in 86.1% of patients. 10% of the patients received medicine to treat dementia (donepezil in 60% of the cases, memantine 40% of the cases). At least one required medication was not administered for 38.9% of dementia patients because of its adverse effect.
Conclusion and Relevance From this investigation we concluded that the active involvement of a clinical pharmacist and the internationally validated clinical database systems are essential. They enhance the clinical effectiveness of the medication by reducing multiple drug uses and by eliminating adverse drug reactions. Our real-world study is highly beneficial for the individualised medication of dementia patients receiving chronic hospital cares.
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