Naslov
Compliance with treatment guidelines for psychotic fetaures in dementia of the Alzheimer's type on a hospital ward

Autori
Novy-Radonić, Ernestina ; Erdeljić, Viktorija ; Radonić, Elizabeta ; Henigsberg, Neven

Izvornik
Pharmaca : hrvatski časopis za farmakoterapiju (0031-6857) 47 (2009), 1; 17-24

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
compliance ; guidelines ; Psychotic features ; Alzheimer's dementia

Sažetak
Psychotic features are reported in at least 25% of mildly demented and 50% of patients with advanced Alzheimer's disease. Treatment guidelines recommend the use of antipsychotic therapy only for severe symptoms, their use be preferably restricted to only one agent at time, targeted to the lowest possible dosage to control symptoms. The choice of drug should be made on a case-by-case basis, as there is no clear evidence to indicate superior efficacy or adverse event profile of atypical antipsychotics in comparison to conventional antipsychotics. The aim of this survey was to test the compliance with these treatment guidelines at a hospital ward. Pharmacotherapy data (drug and dosage per day) were collected from patient medication lists on a female prolonged treatment ward. Included were data for patients with clinical diagnosis of dementia of the Alzheimer's type with marked psychotic features at the beginning of the treatment (Clinical Global Impression Scale, CGI ≥ 4), at least minimal clinical improvement at discharge (CGI ≤ 3), and either none or minimal side effects that did not significantly interfere with patient functioning. Fifty one patients fulfilled the criteria over a 5-year survey period. Basic demographic and clinical course data were collected as well (age, duration of illness, number of hospitalizations). Descriptive statistics was used to analyze demographic, clinical and pharmacotherapy data. The mean patient age was 74.7 years, the mean duration of illness 4.5 years, with a mean of two hospitalizations. The majority of patients (70.6%) received monotherapy. Prescribed antipsychotics included promazine, fluphenazine, clozapine, risperidone and quetiapine. Promazine was most frequently prescribed, and in combination therapy it was the second antipsychotic for all patients. Delivered daily doses were in accordance to dose range recommended for dementia-related psychotic features in elderly. Antipsychotic treatment during the observed period was in compliance with treatment guidelines. Since the inclusion criteria were at least minimal clinical improvement and none or minimal side effects, the data from this sample support the conclusion that both conventional and atypical antipsychotics have good safety and efficacy profiles in the treatment of psychotic features in Alzheimer's dementia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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