Dementia‐specific drug treatment in home care settings: A German multicentre study

Abstract

Aims and objectives The aim of this study was to identify and analyse factors influencing the use of drugs for dementia treatment in home care settings. Background While the number of care‐dependent people with dementia is growing, it is not clear whether their medication follows the state of the art, especially in home care settings where over two‐thirds of them are cared for in Germany. Although dementia is not curable, it is possible to reduce cognitive, behavioural and psychological symptoms of dementia with the appropriate use of medication. However, there is a lack of information concerning the drug treatment in home care settings. Methods The study was conducted as a multicentre cross‐sectional survey, including 923 participants from 102 home care institutions throughout Germany. Medical diagnosis, medication, consultations with a specialist within the previous 12 weeks of the initial assessment and additional general information were assessed following a standardised study protocol. Data were analysed using univariate and multivariate statistical methods. The manuscript was developed utilising the STROBE checklist for cross‐sectional studies. Results In home care, one in seven clients (14.8%) is diagnosed with some form of dementia. 52.6% (n = 72) of them were treated with dementia medication: AchEIs 16.1% (n = 22), memantine 9.5% (n = 13), antidepressants 23.4% (n = 32), antipsychotic medication 9.5% (n = 13), tranquilisers 16.8% (n = 23) and anticonvulsant drugs 6.6% (n = 9). Drug treatment for dementia was significantly associated with the consultation of a neurologist/psychiatrist in the previous 12 weeks. Conclusions It has been demonstrated that the use of drugs as a component of home care treatment for dementia depends on many factors and therefore varies. Relevance to clinical practice It can be assumed that people living with dementia in home care settings are not sufficiently supplied with medication. Their medical care can be improved by establishing interdisciplinary care involving a neurologist/psychiatrist.

Dementia care and the role of guideline adherence in primary care: cross-sectional findings from the DemTab study

“…For example, for individuals diagnosed with Alzheimer’s Disease and a mild to moderate cognitive impairment, the intake of Acetylcholinesterase inhibitors is recommended [ 28 ]. In the present sample, about 37% of PwD reported the intake of an anti-dementia drug, a finding in line with previous studies [ 47 , 48 ]. For example, a study on medical treatment of PwD in Germany reported 25% of ambulatory PwD receiving an anti-dementia drug, and found that this number varied depending on whether PwD were seen by a GP and specialist or solely a GP (48% versus 24.5%, respectively) [ 49 ].…”

“…For example, a study on medical treatment of PwD in Germany reported 25% of ambulatory PwD receiving an anti-dementia drug, and found that this number varied depending on whether PwD were seen by a GP and specialist or solely a GP (48% versus 24.5%, respectively) [ 49 ]. Past research has consistently reported a positive association between involvement of a GP/specialist and anti-dementia drug prescription [ 48 , 50 ]. In the present study, about 10% of PwD reported the intake of an anti-dementia drug which was not in line with GDG recommendations, and almost half (44.5%) reported an intake of off-label drugs.…”

Dementia Care and the Role of Guideline Adherence in Primary Care: Cross-Sectional Findings From the DemTab Study

“…For example, for individuals diagnosed with Alzheimer's Disease and a mild to moderate cognitive impairment, the intake of Acetylcholinesterase inhibitors is recommended (28). In the present sample, about 37% of PwD reported the intake of an anti-dementia drug, a nding in line with previous studies (48,49). For example, a study on medical treatment of PwD in Germany reported 25% of ambulatory PwD receiving an anti-dementia drug, and found that this number varied depending on whether PwD were seen by a GP and specialist or solely a GP (48% versus 24.5%, respectively) (50).…”

“…For example, a study on medical treatment of PwD in Germany reported 25% of ambulatory PwD receiving an anti-dementia drug, and found that this number varied depending on whether PwD were seen by a GP and specialist or solely a GP (48% versus 24.5%, respectively) (50). Past research has consistently reported a positive association between involvement of a GP/specialist and anti-dementia drug prescription (49,51). In the present study, about 10% of PwD reported the intake of an anti-dementia drug which was not in line with GDG recommendations, and almost half (44.5%) reported an intake of off-label drugs.…”