Practical tool to offer better informed care for people living with dementia
Our researchers at the Kolling Institute are working to improve the use of medications for dementia with a comprehensive analysis highlighting several concerning trends. The latest data indicates more than 420,000 people are living with dementia in Australia, including more women than men. The condition is the second leading cause of death in Australia. Leading researcher and member of the Kolling’s Neuroscience and Pain Priority Research Area Dr Edwin Tan said people with dementia are high users of medications due to the challenging symptoms of the condition and the combination of other chronic conditions. “We found there was often limited evidence for prescribing medications for people with dementia, and clinicians were left to weigh up the risks and benefits of these medications,” he said. “Our analysis of nationwide data found 60 per cent of people with dementia are taking a psychotropic medication like an anti-depressant, antipsychotic or opioid, and 26 per cent are taking an anti-dementia medication like Aricept, Exelon or Reminyl.
“We were interested to find that when we looked at people’s backgrounds, those from a higher socio-economic group were more likely to take an anti-dementia medication, compared with people from a rural or regional area, or those with limited access to healthcare, who were more likely to take a psychotropic drug, like an antipsychotic. “Concerningly, two thirds of people with dementia are taking at least five medications and 23 per cent are taking more than ten medications.” Researchers were also concerned to see the number of high-risk combinations of drugs, with 14 per cent of people with dementia taking all four high-risk medication groups, including sedatives. The data pointed to an increased risk of medication poisoning, with one in five people experiencing an adverse drug event. Researchers identified 15 per cent of people with dementia experienced drug poisoning, compared with just two per cent of the general older population.
Dementia increased a person’s risk of poisoning by an alarming 77 per cent. Dr Tan is now working to develop a personalised antipsychotic calculator to assist with safer prescribing and shared decision making. “Working with patients, clinicians and carers, I am keen to develop a tool which will weigh the risks and benefits of antipsychotic medications to help ensure patients are prescribed the best medication for their individual needs,” said Dr Tan. “An evidenced-based tool, which would predict the likelihood of treatment response and adverse events, could greatly assist personal treatment plans and improve patient outcomes.”
Photo: Dementia image and photo of
Dr Edwin Tan
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