Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3326176 | NPG Neurologie - Psychiatrie - Gériatrie | 2013 | 10 Pages |
Abstract
At the end of 2011, the High Health Authority (HAS) had published its prescribing recommendations for three acetylcholinesterase inhibitors (IAChe-donepezil, rivastigmine and galantamine) and memantine for the therapeutic management of this condition. In this study, we have focused particularly on assessing the practical application of these recommendations in five EHPAD of the Mulhouse surrounding area (Alsace, France). Of the 402Â residents identified, the absence of cognitive impairment in the medical record was found in 191Â cases (47.5%). Among the 211Â cases of dementia (52.5%), one third was AD (35.6%), 15.2% mixed or multifactor dementia and 13.7% of vascular origin. In one third of cases (29.9%) the diagnosis was not specified. The history of prescription of the 402Â residents identified 86Â prescriptions containing at least one specific treatment of AD (21.4%). This treatment was still prescribed on the day of the survey in 65Â patients (16.2%). Appropriate prescription (mono-dose daily and right dosage in terms of diagnosis and stage) was observed in 55.9% of cases for memantine and 52.3% of cases for IAChE. Twenty-nine prescriptions were consistent (49.2%) with the recommendations of the HAS. By taking into account the prescribed daily dose then only 25 (42.4%) were in line with the recommendations. In other words, nearly one prescription out of 2 (44.1%) represented misuse. The 21Â prescriptions stopped concerned IAChE for 9, memantine for 8Â and the remaining 4Â by combination therapies (IAChE and memantine). Although in 48.0% of cases the main reason was a too advanced stage of the disease, in 19.0% it was not found.
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Geriatrics and Gerontology
Authors
S. Maire, P.-O. Lang, G. Kaltenbach, T. Vogel,