Use of donepezil for the treatment of mild-moderate Alzheimer's disease: an audit of the assessment and treatment of patients in routine clinical practice.
There have been a number of randomised, placebo-controlled trials of donepezil in the treatment of mild-moderate Alzheimer's disease and these report significant benefits for a proportion of patients. Little is known about the use of donepezil in routine clinical practice. The aims of this study were to examine the use of donepezil in routine clinical practice and to identify some of the practical and resource implications associated with treatment. A number of areas were examined against published guidelines including assessment, diagnosis, initiation of treatment, monitoring and discontinuation of treatment. This was a retrospective case note study involving patients with mild - moderate Alzheimer's disease over a one-year period. One hundred and seventeen patients were commenced on donepezil and 93 successfully completed three months of treatment. Of these, 47% demonstrated an improvement in cognition, activities of daily living or carer observation (or a combination). Compliance with accepted guidelines with respect to assessment, diagnosis and monitoring requires a standardised approach that has both clinical and resource implications.
Cameron
I
I
Consultant in Public Health Medicine, Leeds Health Authority, Leeds, UK.
Curran
S
S
Newton
P
P
Petty
D
D
Wattis
J
J
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D003071:Cognition / Q000187:drug effects; D000077265:Donepezil; D004363:Drug Utilization / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D006113:United Kingdom
D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil