De­men­tia pa­tients get in­cor­rect meds, study says

Las Vegas Review-Journal (Sunday) - - HEALTH - By Natalie Grover

More than half of el­derly pa­tients with de­men­tia are pre­scribed at least one po­ten­tially in­ap­pro­pri­ate med­i­ca­tion, a re­cent study from eight Euro­pean coun­tries sug­gests.

Some medicines are not typ­i­cally given to older pa­tients be­cause the po­ten­tial side ef­fects out­weigh their clin­i­cal ben­e­fit and be­cause there are of­ten safer or more ef­fec­tive al­ter­na­tives avail­able.

Re­searchers who stud­ied more than 2,000 peo­ple with de­men­tia from Eng­land, Es­to­nia, Fin­land, France, Ger­many, the Nether­lands, Spain and Swe­den found that 60 per­cent had been pre­scribed at least one po­ten­tially in­ap­pro­pri­ate drug, while over 25 per­cent had re­ceived at least two such medicines.

In par­tic­u­lar, de­men­tia pa­tients age 80 or older who were liv­ing in longterm care fa­cil­i­ties were at higher risk of re­ceiv­ing two or more such po­ten­tially un­suit­able medicines, ac­cord­ing to Dr. Anna Renom-Guit­eras of Univer­sity Hos­pi­tal Parc de Sa­lut Mar in Barcelona, Spain and col­leagues.

The pre­scrip­tion of two or more in­ap­pro­pri­ate med­i­ca­tions was as­so­ci­ated with a higher chance of at least one fall-re­lated in­jury and at least one episode of hos­pi­tal­iza­tion, the re­searchers re­ported in Age and Age­ing, on­line Sept. 1.

The find­ings are drawn from in­ter­views with pa­tients and care­givers con­ducted be­tween 2010 and 2012, and from med­i­cal records. Pa­tients were ei­ther liv­ing in a long-term care fa­cil­ity or were re­ceiv­ing care at home but were at risk for need­ing in­sti­tu­tional care in the com­ing six months.

Drugs were con­sid­ered po­ten­tially in­ap­pro­pri­ate for the el­derly if they ap­peared on a list pub­lished in 2015 by a team of Euro­pean ex­perts.

“This is an in­ter­est­ing and use­ful study which con­firms what most de­men­tia spe­cial­ists have been aware of for a long time,” said Dr. Christo­pher Soosay, con­sul­tant psy­chi­a­trist at London-based De­men­tia Spe­cial­ists LLP.

The most fre­quently pre­scribed po­ten­tially in­ap­pro­pri­ate drugs in the study were medicines for acid-re­lated dis­or­ders and psy­c­holep­tics, in­clud­ing an­tipsy­chotics, which pro­duce a calm­ing ef­fect but also af­fect mental func­tion.

In about half of peo­ple with de­men­tia, an­tipsy­chotic drugs do not work, ac­cord­ing to the UK-based Alzheimer’s So­ci­ety.

De­men­tia is a syn­drome char­ac­ter­ized by de­te­ri­o­ra­tion in mem­ory, think­ing, be­hav­ior and daily func­tion­ing.

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