Monitoring compliance with Clinical Protocol and Therapeutic Guidelines for Alzheimer’s disease

Abstract

Dementia is a chronic neurodegenerative disease and Alzheimer’s disease (AD) is the most prevalent type. Objective: To describe the drug monitoring of patients enrolled in a Clinical Protocol and Therapeutic Guidelines of Alzheimer’s Disease (PCDTDA) in Brazil. Methods: A descriptive study based on interviews conducted in 2017 was performed. Patients diagnosed with Alzheimer’s disease (AD) enrolled on the PCDTDA were included. The variables assessed were age, sex, time since diagnosis, clinical parameters of Mini-Mental State Exam (MMSE) and Clinical Dementia Rating (CDR), drug therapy used and AD drug collection. Results: The drug monitoring of 143 patients was evaluated. Observing the requirements of the screening tests for patient enrolment on the PCDTDA, all patients had scores for at least one MMSE and CDR assessment at protocol admission. None of the patients underwent the first reassessment of the effectiveness of AD drug therapy or the semiannual reassessment. Conclusion: Although PCDTDA provides the best evidence of AD treatment, the data showed failures in the monitoring of the effectiveness of AD drug therapy at dispensing.

Impact of pharmacist intervention in patients with Alzheimer's disease

“…The proposed intervention was observed to make an effective contribution to compliance with the PCDTDA, as there were weaknesses in patient inclusion (Picon et al, 2010) and monitoring of the protocol (Forgerini, Mastroianni, 2020).…”

“…In addition, studies have found that among these patients, approximately 65 -93% of them had at least one DRPs (Gustafsson et al, 2016;Wucherer et al, 2017), such as use of potentially inappropriate drugs (Forgerini et al, 2020), therapeutic ineffectiveness, use of unnecessary drugs (Gustafsson et al, 2016), and treatment nonadherence that could range from 17% to 100% (Smith et al, 2017;Wucherer et al, 2017).…”

Risk factors associated with drug therapy among elderly people with Alzheimer’s disease: a cross-sectional study

“…These findings show that no monitoring of the effectiveness of this drug therapy was being done and, consequently, that there was non-compliance with the guidelines recommended in the PCDTDA/MS. 48 Therefore, the "minor" complexity of the drug therapy for these elderly individuals with AD did not mean that there were no safety issues or drug-related problems (DRPs) to be identified, prevented, monitored and resolved.…”

Avanços no diagnóstico precoce da Doença de Alzheimer e novas perspectivas de tratamento: uma revisão sistemática da literatura / Advances in early diagnosis of Alzheimer's disease and new treatment perspectives: a systematic review of the literature

“…sintomas psicológicos e comportamentais da demência. Desse modo, a terapêutica é considerada paliativa e apresenta falhas para a resolução da enfermidade17 , assim os Brazilian Journal of Health Review, Curitiba, v.4, n.3, p. 10121-10135 may./jun. 2021 a intervenção in vivo com estatinas modifica a oxidação do LDL-L e exerce um efeito protetor contra o dano microvascular.…”