June 6, 2016

Having a pharmacist as part of a health care team can improve care for anyone living with Alzheimer’s or other forms of dementia, according to a new report. The study found that involving pharmacists led to better care and halved the risk that someone with Alzheimer’s would be admitted to the hospital because of drug-related problems.

People living with Alzheimer’s disease often have to take a variety of medications, not just for Alzheimer’s but often for a range of medical complaints associated with aging. For someone coping with memory loss, managing these medications can be a challenge. Missing a dose of a drug, or taking too high a dose, can lead to life-threatening medical problems.

Drugs can also produce troubling side effects, and taking multiple medications for various complaints further accentuate this problem and can lead to dangerous drug interactions. Drug-related medical problems may lead to emergency situations and require admission to a hospital. But pharmacists can help prevent these dangerous drug-related medical problems, the new report showed.

For the study, doctoral student and clinical pharmacist Maria Gustafsson at the Department of Community Medicine and Rehabilitation at Umea University in Sweden looked at 460 men and women living in northern Sweden who had been admitted to the hospital between 2012 and 2015. All were older than 65 and had Alzheimer’s or other forms of dementia.

“We found that as many as 41 per cent of all hospital admissions were related to medication events,” Ms. Gustafsson said. “The most common problem was adverse drug reactions. But excessively high dosage and noncompliance was, unfortunately, common.”

For the study, pharmacists were enlisted to help with these patients’ care. Over the next six months, they checked to make sure that patients were getting the right medications for their medical issues. They also suggested potential improvements in the medication list to the doctor in charge and participated in discussions with the health care team.

“The results after the intervention showed that clinical pharmacists’ participation in health care teams reduced the risk of drug-related hospital readmissions by half during the follow-up time,” Ms. Gustafsson said.

The study found that antipsychotic medications were a particular source of problems. Antipsychotic drugs like Haldol and Risperdal are commonly prescribed to treat aggression and other behavioral problems in those with Alzheimer’s, particularly in nursing homes. The pharmacists said that such drugs were often inappropriately prescribed for long periods of time. Experts say that if these risky drugs are used, in most cases they should be used only for short periods of time.

“Drug treatment-related problems in elderly people with dementia are very common,” Ms. Gustafsson concluded. “More work is needed in order to prevent, identify and treat these problems.”

The findings underscore the importance of recognizing that medications can be an important source of serious medical issues in those with Alzheimer’s disease. Experts recommend that the elderly and their caretakers regularly review their use of medications with health professionals so that prescriptions can be adjusted as needed.

Those caring for a loved one with Alzheimer’s should also take special care to assure that medications are taken as directed. Enlisting the help of a pharmacist, the study shows, can help to identify serious adverse reactions or potentially dangerous problems.

By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Maria Gustafsson, doctoral student at the Department of Community Medicine and Rehabilitation, Geriatric at Umea University, Sweden.