Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer's Disease.
Background: There is a substantial risk of drug-interactions, adverse events, and inappropriate drug use (IDU) among frail Alzheimer's disease (AD) patients; however, there are few studies about co-medication and IDU in clinical settings. Objectives: To investigate anti-dementia drugs, associated ch...
| Published in: | Drugs & Aging Vol. 31; no. 3; pp. 215 - 225 |
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| Main Authors: | , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Mar2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104034211&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104034211 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1170229X C5B jtl: Drugs & Aging issn: 1170229X maglogo: N pubinfo: dt: Mar2014 vid: 31 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104034211 94694335 10.1007/s40266-014-0154-8 NLM24497071 104034211 ppf: 215 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer's Disease. aug: au: Fereshtehnejad, Seyed-Mohammad Johnell, Kristina Eriksdotter, Maria affil: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Novum 5th floor 14186 Stockholm Sweden sug: subj: Alzheimer's Disease Drug Therapy Inappropriate Prescribing Polypharmacy Dementia Drug Therapy Cholinesterase Inhibitors Aspartic Acid Antagonists and Inhibitors Aspartic Acid Classification Human Cross Sectional Studies Clinical Assessment Tools Data Analysis Software T-Tests Multivariate Analysis Chi Square Test ab: Background: There is a substantial risk of drug-interactions, adverse events, and inappropriate drug use (IDU) among frail Alzheimer's disease (AD) patients; however, there are few studies about co-medication and IDU in clinical settings. Objectives: To investigate anti-dementia drugs, associated characteristics of cholinesterase inhibitors (ChEIs) and NMDA antagonists, co-medication, and IDU in a large population of outpatients with mild AD. Methods: In this cross-sectional analysis of medication characteristics, we analyzed data from the Swedish Dementia Quality Registry (SveDem) on 5,907 newly diagnosed AD patients who were registered in memory clinics. SveDem is a national quality registry in Sweden, which was established in 2007 to evaluate and improve dementia healthcare. Comparisons were performed concerning co-medications, use of ≥3 psychotropic drugs (IDU) and polypharmacy (≥5 drugs) based on anti-dementia treatment (ChEIs or NMDA antagonists). Information on baseline characteristics such as age, sex, living conditions, cognitive evaluation based on the Mini-Mental State Examination (MMSE) score, and diagnostic work-up was also evaluated. Results: The majority of the AD patients were in the mild stage of the disease. Overall, 4,342 (75.4 %) patients received any ChEI, 438 (7.6 %) used an NMDA antagonist and 74 (1.3 %) patients were treated with both. However, 907 (15.7 %) patients were not treated with any anti-dementia drug. While polypharmacy was seen in 33.5 % of patients, only 2.6 % concurrently used ≥3 psychotropic medications. Patients on ChEIs were significantly younger, had a higher MMSE score and were treated with a smaller number of medications (a proxy for overall co-morbidity). Co-medication with antipsychotics [3.3 vs. 7.6 %; adjusted odds ratio (OR) 0.55 (95 % CI 0.38-0.79)] and anxiolytics [5.8 vs. 10.9 %; adjusted OR 0.62 (95 % CI 0.46-0.84)] was significantly lower in the ChEI+ group than in those with no anti-dementia treatment. Conclusion: Patients taking ChEIs were treated with less antipsychotics and anxiolytics than those not taking ChEIs. More research is warranted to elucidate whether use of ChEIs in clinical practice can reduce the need for psychotropic drugs in AD patients. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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