Initiating and monitoring cholinesterase inhibitor treatment for Alzheimer's disease.
The availability of acetylcholinesterase inhibitors for the treatment of Alzheimer's disease raises a number of clinical and ethical questions. Many of the guidelines published in an attempt to tackle these questions lack either clinical or scientific validity. Against this background a model is proposed whereby specialist monitoring using formal tests is neither appropriate nor necessary to determine whether an individual patient should continue or stop treatment. Instead the primary care physician should refer potentially suitable patients for specialist assessment to confirm the diagnosis/He/she should then initiate, monitor, and discontinue treatment based on the establishment of realistic treatment goals agreed with the patient/carer at the outset.
Swanwick
G R
GR
Mercer's Institute for Research on Ageing and Eastern Health Board, Ireland.
Lawlor
B A
BA
D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods*; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012944:Social Support; D006113:United Kingdom
D002800:Cholinesterase Inhibitors