Background: Advanced dementia is a prevalent health problem in geriatric patients. These patients
usually suffer from several chronic diseases, frequently leading to an end-of-life situation lasting months
or years, generating complex and often inappropriate medication regimens.
Objectives: Describe the re-orientation of drug ...»»»»
Background: Advanced dementia is a prevalent health problem in geriatric patients. These patients
usually suffer from several chronic diseases, frequently leading to an end-of-life situation lasting months
or years, generating complex and often inappropriate medication regimens.
Objectives: Describe the re-orientation of drug therapy in patients with advanced dementia utilizing a
systematic medication review process.
Methods: This non-experimental pre-post analysis included all patients with advanced dementia
admitted to acute geriatric unit (AGU) over one year. Medications were reviewed by a multidisciplinary
team and together with the patient caregivers; new therapeutic objectives based on end-of-life care
principles were established. Medications were classified as preventive, therapeutic, or symptomatic. The
average number of medications per patient pre- and post-admission was compared.
Results: We included 73 patients (mean age 86.1 years, mean Barthel Index: 14.5/100). At admission,
patients had a mean of 7.27 drugs compared to 4.82 at discharge (66.85% reduction, P < 0.05). The main
drugs withdrawn were cardiovascular and hematological (35.76%). Drugs for prevention decreased by
66.85% (from 1.8 to 0.6, P < 0.05) and those for symptomatic care decreased by 17,52% (from 2.34 to 1.93,
P < 0.05).
Conclusion: Medication therapy plans in patients with advanced dementia often do not meet their
therapeutic goals. The proposed methodology is a useful tool to assess therapeutic appropriateness.^^^^