A new study has taken an important step towards improving medicines management for people living with dementia.
Fifty-seven experts from around Australia (58% of whom were pharmacists) have reached consensus on what is Medication Appropriateness for comorbid health conditions for people who also have dementia, lead author Amy Page told the AJP today.
“These statements provide consensus-based guidance for managing medications for people who have a diagnosis of dementia,” she says.
“Most people living with dementia have at least one other health condition.
“They often use medications to manage their other health conditions, but we don’t have much information to guide us on whether this is appropriate.
“Tools such as the STOPP/START criteria and the Beers Criteria are great to help guide therapy for older adults generally, but people living with dementia have specific needs as they are living with a progressive life-limiting condition.”
The study, Medication Appropriateness Tool for Comorbid Health Conditions in Dementia (MATCH-D): Consensus recommendations from a multidisciplinary expert panel, included 57 pharmacists, doctors, nurse practitioners, a psychologist and a patient advocate from around the country, and used the Delphi method to develop a consensus. This required three rounds of surveys.
“We asked them open-ended questions about their roles and experience in managing medications for people with dementia,” says Page, who was named PSA Young Pharmacist of the Year in 2015.
“This data was analysed, and turned into statements.
“The participants were asked in the second round and third round statements about their agreement with the questions. This agreement was rated on a 5-point Likert-scale.
“The statements that we reached consensus on have then been included in the Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria.”
These statements were on a variety of broad themes: preventative medication, symptom management, disease progression, psycho-active medication, treatment goals, principles of medication use, side effects, and medication reviews.
For example, the section of MATCH-D criteria looking at medication reviews states than when reviewing medicines use for people living with dementia, health professionals should check that each medication is:
- underpinned by a current, valid indication;
- effective for that individual;
- consistent with the individual’s care goals; and
- documented with a time frame to review.
“The experts emphasised the need for each person to be treated as an individual and for their therapy to match their own health goals,” says Page.
“They have suggested areas where appropriate therapy changes as dementia progresses from the early to the mid to the late stages.
“This research provides consensus-based guidance for clinicians who manage comorbid health conditions in people with dementia.”
Page and her colleagues are continuing research into developing a prescribing decision aid to support clinicians prescribing for people living with dementia.
They are seeking pharmacists and other health professionals who are willing to participate in a one-hour focus group to discuss medication use for people living with dementia in Perth, and willing to declare any conflicts of interest.
Potential participants can contact Amy Page (PhD candidate) firstname.lastname@example.org or Professor Christopher Etherton-Beer Christopher.email@example.com. The research is undertaken by the School of Medicine and Pharmacology at the University of Western Australia.