Title : Quality improvement in pharmacological treatment for dementia patients an integrative literature review
Aim: To determine the appropriate nonpharmacological interventions and pharmacological treatments that are beneficial for dementia patients, and how and when they should be initiated or discontinued.
Background: Alzheimer’s dementia is a progressive, disabling disease that affects approximately 6.2 million Americans aged 65 and older every year. Historically, Alzheimer’s dementia was treated with antipsychotics.
Methodology: Whittemore and Knafl methodological approach to integrative literature reviews was used. A search resulted in 18 empirical and theoretical articles on the pharmacologic management of dementia patients.
Findings: Nonpharmacological interventions which include identification and removal of triggers, effective communication, and treatment of underlying medical conditions should be used as the first line of treatment. Medications should only be initiated when dementia patients pose a threat to themselves, the caregiver, or if nonpharmacological interventions fail. The medication should be initiated at the lowest dose for the shortest duration of time and reassessed at least annually or more frequently as necessary.
Recommendations: Establishment of standardized care plans for Alzheimer’s dementia, combined with continued research in management and treatment are needed. Education is needed to alleviate the danger to patients and caregivers.