Medication use to manage comorbidities for people with dementia: A Systematic Review

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Abstract

Aim
People with dementia commonly live with multiple comorbidities. This review aimed to review medications to manage chronic conditions in people who also have a diagnosis of dementia. The secondary aim was to determine whether drug utilisation for other conditions change as a result of dementia diagnosis.

Methods
Data source: We included experimental and observational studies where participants with dementia were diagnosed and treated for one or more comorbid conditions that reported health outcomes or drug utilisation. Study selection: MedLine and Embase databases were searched from inception to March 2016 (updated September 2016). Three researchers screened titles, abstracts and full‐text articles, then extracted data using a data extraction sheet.

Results
Six studies met inclusion criteria with 51 696 participants (mean age 81.1 ± 2.0 years, 78% female). One experimental study compared bisphosphonate use with placebo in people with mid‐stage dementia and found reduced risk of non‐vertebral fractures (OR = 0.27, 95% CI 0.12–0.61) in the bisphosphonate group. Five observational studies reported drug utilisation for people with dementia to treat comorbidities, namely depression, osteoporosis, diabetes and cardiovascular disease. Drug utilisation was found to be similar for depression, diabetes and cardiovascular disease for people with and without dementia, although bisphosphonate use was significantly reduced.

Conclusion
Evidence on medication use for comorbidities in people with dementia is currently limited to drug utilisation patterns and treatment of one comorbidity: osteoporosis. Comorbidities for people with dementia appear to be managed pharmacologically until the late stages of disease without considering time to benefit or that it is a life‐limiting condition.
Original languageEnglish
Pages (from-to)356-367
JournalJournal of Pharmacy Practice and Research
Volume48
Issue number4
DOIs
Publication statusE-pub ahead of print - 2018

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Dementia
Comorbidity
Drug Utilization
Diphosphonates
Osteoporosis
Observational Studies
Cardiovascular Diseases
Depression
Placebos
Research Personnel
Databases
Health

Cite this

@article{5725ca1119e549468f2532da0daf3f98,
title = "Medication use to manage comorbidities for people with dementia: A Systematic Review",
abstract = "AimPeople with dementia commonly live with multiple comorbidities. This review aimed to review medications to manage chronic conditions in people who also have a diagnosis of dementia. The secondary aim was to determine whether drug utilisation for other conditions change as a result of dementia diagnosis.MethodsData source: We included experimental and observational studies where participants with dementia were diagnosed and treated for one or more comorbid conditions that reported health outcomes or drug utilisation. Study selection: MedLine and Embase databases were searched from inception to March 2016 (updated September 2016). Three researchers screened titles, abstracts and full‐text articles, then extracted data using a data extraction sheet.ResultsSix studies met inclusion criteria with 51 696 participants (mean age 81.1 ± 2.0 years, 78{\%} female). One experimental study compared bisphosphonate use with placebo in people with mid‐stage dementia and found reduced risk of non‐vertebral fractures (OR = 0.27, 95{\%} CI 0.12–0.61) in the bisphosphonate group. Five observational studies reported drug utilisation for people with dementia to treat comorbidities, namely depression, osteoporosis, diabetes and cardiovascular disease. Drug utilisation was found to be similar for depression, diabetes and cardiovascular disease for people with and without dementia, although bisphosphonate use was significantly reduced.ConclusionEvidence on medication use for comorbidities in people with dementia is currently limited to drug utilisation patterns and treatment of one comorbidity: osteoporosis. Comorbidities for people with dementia appear to be managed pharmacologically until the late stages of disease without considering time to benefit or that it is a life‐limiting condition.",
author = "Page, {Amy Theresa} and Christopher Etherton-Beer and Liza Seubert and Vaughan Clark and Xaysja Hill and S. King and Rhonda Clifford",
year = "2018",
doi = "10.1002/jppr.1403",
language = "English",
volume = "48",
pages = "356--367",
journal = "Australian Journal of Hospital Pharmacy",
issn = "0310-6810",
publisher = "Society of Hospital Pharmacists of Australia",
number = "4",

}

TY - JOUR

T1 - Medication use to manage comorbidities for people with dementia

T2 - A Systematic Review

AU - Page, Amy Theresa

AU - Etherton-Beer, Christopher

AU - Seubert, Liza

AU - Clark, Vaughan

AU - Hill, Xaysja

AU - King, S.

AU - Clifford, Rhonda

PY - 2018

Y1 - 2018

N2 - AimPeople with dementia commonly live with multiple comorbidities. This review aimed to review medications to manage chronic conditions in people who also have a diagnosis of dementia. The secondary aim was to determine whether drug utilisation for other conditions change as a result of dementia diagnosis.MethodsData source: We included experimental and observational studies where participants with dementia were diagnosed and treated for one or more comorbid conditions that reported health outcomes or drug utilisation. Study selection: MedLine and Embase databases were searched from inception to March 2016 (updated September 2016). Three researchers screened titles, abstracts and full‐text articles, then extracted data using a data extraction sheet.ResultsSix studies met inclusion criteria with 51 696 participants (mean age 81.1 ± 2.0 years, 78% female). One experimental study compared bisphosphonate use with placebo in people with mid‐stage dementia and found reduced risk of non‐vertebral fractures (OR = 0.27, 95% CI 0.12–0.61) in the bisphosphonate group. Five observational studies reported drug utilisation for people with dementia to treat comorbidities, namely depression, osteoporosis, diabetes and cardiovascular disease. Drug utilisation was found to be similar for depression, diabetes and cardiovascular disease for people with and without dementia, although bisphosphonate use was significantly reduced.ConclusionEvidence on medication use for comorbidities in people with dementia is currently limited to drug utilisation patterns and treatment of one comorbidity: osteoporosis. Comorbidities for people with dementia appear to be managed pharmacologically until the late stages of disease without considering time to benefit or that it is a life‐limiting condition.

AB - AimPeople with dementia commonly live with multiple comorbidities. This review aimed to review medications to manage chronic conditions in people who also have a diagnosis of dementia. The secondary aim was to determine whether drug utilisation for other conditions change as a result of dementia diagnosis.MethodsData source: We included experimental and observational studies where participants with dementia were diagnosed and treated for one or more comorbid conditions that reported health outcomes or drug utilisation. Study selection: MedLine and Embase databases were searched from inception to March 2016 (updated September 2016). Three researchers screened titles, abstracts and full‐text articles, then extracted data using a data extraction sheet.ResultsSix studies met inclusion criteria with 51 696 participants (mean age 81.1 ± 2.0 years, 78% female). One experimental study compared bisphosphonate use with placebo in people with mid‐stage dementia and found reduced risk of non‐vertebral fractures (OR = 0.27, 95% CI 0.12–0.61) in the bisphosphonate group. Five observational studies reported drug utilisation for people with dementia to treat comorbidities, namely depression, osteoporosis, diabetes and cardiovascular disease. Drug utilisation was found to be similar for depression, diabetes and cardiovascular disease for people with and without dementia, although bisphosphonate use was significantly reduced.ConclusionEvidence on medication use for comorbidities in people with dementia is currently limited to drug utilisation patterns and treatment of one comorbidity: osteoporosis. Comorbidities for people with dementia appear to be managed pharmacologically until the late stages of disease without considering time to benefit or that it is a life‐limiting condition.

U2 - 10.1002/jppr.1403

DO - 10.1002/jppr.1403

M3 - Review article

VL - 48

SP - 356

EP - 367

JO - Australian Journal of Hospital Pharmacy

JF - Australian Journal of Hospital Pharmacy

SN - 0310-6810

IS - 4

ER -