Category: Federal Forum Posters
Purpose: Prescribing and follow-up in patients with dementia can be complex. Specifically, anticholinergics, antipsychotics, and benzodiazepines should be avoided in patients with dementia. Anticholinergics can mimic or worsen dementia symptoms. Antipsychotics and benzodiazepines increase the risk of death in patients with dementia. Despite these risks, they are often prescribed in this population. Regular monitoring of cognitive changes allows for the detection of new symptoms and re-evaluation of treatment decisions. The purpose of this study was to determine the prevalence of anticholinergic, antipsychotic, and benzodiazepine prescriptions in this population along with the monitoring of AChEIs in the primary care setting.
Methods: This study was conducted through a chart review of veterans if he or she had an active prescription for one of three acetylcholinesterase inhibitors (donepezil, rivastigmine, or galantamine) at the determined retrieval date. Veterans were excluded from the review if they had not received the medication for at least one year prior to the review date or the prescription was not prescribed by a primary care provider. The primary outcome for this study was the frequency of anticholinergic, antipsychotic, and benzodiazepine prescriptions used in patients with dementia on acetylcholinesterase inhibitors. Medication lists were reviewed for these medications, and if they were determined to be on an anticholinergic, antipsychotic, or benzodiazepine; the indications, prescribers names, and length of therapy for these veterans. Secondary outcomes for this review include diagnosis at initiation of therapy, a documented cognitive test (Mini-Mental Status Exam, Montreal Cognitive Assessment, Mini-Cog, Functional Assessment Staging Test, or Saint Louis University Mental Status Examination) during the previous year, length of time to last cognitive test, incidence of bradycardia in the last year, and/or weight loss over the past year
Results: Not applicable
Conclusion: Not applicable
Jordan Michaels– Pharmacy Resident, G.V. (Sonny) Montgomery VA Medical Center, Jackson