Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Aims

1. To explore the relationship between demographics and the usage of cholinesterase inhibitors (AChEIs) and memantine in dementia patients.
2. To evaluate the effect of AChEIs and memantine on deprescribing psychotropics in dementia patients.

Method

A retrospective review of patients who were prescribed AChEIs and memantine in the Cognitive Assessment and Management (CAM) Unit at The Prince Charles Hospital was conducted between 1/1/18 and 31/10/20.   Data from eligible patients were collected and reviewed from the extract of electronic discharge summary program. 

Results

A total of 62 patients were eligible for review during the study period.  The mean age was 78 years, with 44% of the patients were male.  41% of patients were diagnosed with mixed dementia, with an average of 9 medications prescribed on discharge.  Amongst the types of AChEIs in the study, 52% of patients were prescribed rivastigmine.

Regarding the effect of AChEIs on deprescribing psychotropics, amongst the 5% of patients who ceased AChEIs on discharge, at least 67% continued both antipsychotics and benzodiazepines at outpatient review.  Whilst the remaining 95% who continued AChEIs on discharge, only 29% continued both psychotropic drugs; compared to 44% who did not require any psychotropic drugs at outpatient review.

Conclusion

The study demonstrates some effectiveness of AChEIs and memantine on reducing the prescribing of antipsychotics and benzodiazepines in patients with dementia.  Further research may include other objective outcomes such as drug burden index (DBI) which will help construct the full effect of AChEIs and memantine in deprescribing these psychotropics.