Gastrointestinal adverse events in a general population sample of nursing home residents taking cholinesterase inhibitors.
OBJECTIVE
To assess the occurrence of gastrointestinal (GI) adverse events in a national sample of nursing home residents taking donepezil, galantamine, or rivastigmine.


METHODS
A retrospective analysis of the Minimum Data Set (MDS) was performed.


METHODS
Four hundred-fifty-two nursing facilities across the United States.


METHODS
During 2000, 2001, and 2002, eligible residents began donepezil, galantamine, or rivastigmine monotherapy. Among these treatment groups, 5,846, 750, and 1,672 residents, respectively, were included in the analysis. All MDS assessments were analyzed if completed. Analyses were conducted at baseline and within one year of initiating therapy.


METHODS
Occurrence of vomiting, stomach pain, diarrhea, weight loss, and insomnia.


RESULTS
Overall, GI adverse events ranged from 2% to 9% and were comparable among the groups. Residents taking galantamine were more likely to experience diarrhea relative to those taking rivastigmine or donepezil (8.9% versus 6.8% versus 6.4%, respectively; P = 0.035), and less likely to lose weight relative to these groups (15.6% versus 20.0% versus 20.3%, respectively; P = 0.01). GI adverse events were less frequent during the maintenance phase compared with the initial drug-titration phase.


CONCLUSIONS
GI events generally occurred with similar frequency in a national sample of nursing home residents taking donepezil, galantamine, or rivastigmine in the usual clinical practice setting.
Pharmacy Operation and Research, Beverly Enterprises, Fort Smith, Arkansas, USA.
Anthony
A
Hughes
Jonathan
J
Musher
Simu K
SK
Thomas
Kathleen M
KM
Beusterien
Bill
B
Strunk
Stephen
S
Arcona