PMID- 32723787
OWN - NLM
STAT- MEDLINE
DCOM- 20220426
LR  - 20230502
IS  - 2047-9956 (Print)
IS  - 2047-9964 (Electronic)
IS  - 2047-9956 (Linking)
VI  - 29
IP  - 3
DP  - 2022 May
TI  - Discontinuation of cholinesterase inhibitor treatment in institutionalised 
      patients with advanced dementia.
PG  - 145-150
LID - 10.1136/ejhpharm-2019-002106 [doi]
AB  - OBJECTIVE: To evaluate the impact of discontinuation of treatment with 
      cholinesterase inhibitors (ChEIs) on cognitive, behavioural and functional 
      outcomes in patients with severe dementia. METHODS: A prospective observational 
      study in which the prescribing physician decides, depending on multidisciplinary 
      assessment and following the recommendations of the clinical practice guidelines, 
      whether to withdraw or continue ChEI treatment in institutionalised patients, 
      with a follow-up of 3 months. Cognitive abilities were measured using the 
      Mini-Mental State Examination (MMSE) and Reisberg's Global Deterioration Scale 
      (GDS). Other measures were the behavioural and psychological symptoms of dementia 
      (BPSD) according to the Neuropsychiatric Inventory (NPI), the activities of daily 
      living using the Barthel index, the pharmacological and the non-pharmacological 
      measures to treat the BPSD. RESULTS: ChEI treatment was discontinued in 23 of 43 
      patients. After 3 months there were no differences in MMSE (p=0.441), GDS 
      (p=0.976), NPI (p=0.882) or Barthel index (p=0.080) scores, or the establishing 
      of new pharmacological measures (p=0.919) or non-pharmacological measures 
      (p=0.832). CONCLUSIONS: ChEI discontinuation in advanced stage dementia was not 
      related to clinical deterioration in terms of cognitive function, BPSD, or 
      functional status. Discontinuing ChEI treatment according to a multidisciplinary 
      assessment and the recommendation of the guidelines appears to be a possible way 
      of optimising pharmacotherapy without altering the main clinical evaluation 
      scales.
CI  - (c) European Association of Hospital Pharmacists 2022. No commercial re-use. See 
      rights and permissions. Published by BMJ.
FAU - Garcia-Garcia, Ramon
AU  - Garcia-Garcia R
AD  - Pharmacy, Hospital Universitario de Torrevieja, Torrevieja, Spain 
      garciagaram@gmail.com.
AD  - University of Granada, Granada, Spain.
FAU - Calleja-Hernandez, Miguel Angel
AU  - Calleja-Hernandez MA
AD  - University of Granada, Granada, Spain.
AD  - Virgen Macarena University Hospital, Sevilla, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200728
PL  - England
TA  - Eur J Hosp Pharm
JT  - European journal of hospital pharmacy : science and practice
JID - 101578294
RN  - 0 (Cholinesterase Inhibitors)
SB  - IM
MH  - Activities of Daily Living
MH  - *Alzheimer Disease/drug therapy/psychology
MH  - Cholinesterase Inhibitors/therapeutic use
MH  - *Dementia/diagnosis/drug therapy
MH  - Humans
PMC - PMC9047926
OTO - NOTNLM
OT  - clinical pharmacy
OT  - geriatric medicine
OT  - neurology
OT  - pharmacy management (personnel)
OT  - psychiatry
COIS- Competing interests: None declared.
EDAT- 2020/07/30 06:00
MHDA- 2022/04/27 06:00
PMCR- 2023/05/01
CRDT- 2020/07/30 06:00
PHST- 2019/09/30 00:00 [received]
PHST- 2020/06/05 00:00 [revised]
PHST- 2020/06/23 00:00 [accepted]
PHST- 2020/07/30 06:00 [pubmed]
PHST- 2022/04/27 06:00 [medline]
PHST- 2020/07/30 06:00 [entrez]
PHST- 2023/05/01 00:00 [pmc-release]
AID - ejhpharm-2019-002106 [pii]
AID - 10.1136/ejhpharm-2019-002106 [doi]
PST - ppublish
SO  - Eur J Hosp Pharm. 2022 May;29(3):145-150. doi: 10.1136/ejhpharm-2019-002106. Epub 
      2020 Jul 28.