Seminars in Ageing: Quality use of medicines in people with dementia, where to go from here

Presenter: Associate Professor Tuan Nguyen, NARI

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About the presentation

This narrative review aims to discuss why medication use in people with dementia is challenging and how to improve it.

Our findings show that limited literature reporting factors affecting quality use of medicines (QUM) in people with dementia, which can be classified into those related to patients, physicians and the healthcare system. Patient-related factors included the progressive cognitive and functional deterioration; age-related changes in pharmacokinetics and pharmacodynamics; and the fact that dementia often coexists with other chronic diseases, thus being associated with multiple medicines use. Physician-related factors included diagnostic and therapeutic knowledge and skills; and pressure to manage behavioural and psychological symptoms of dementia. System factors included failure to coordinate care; lack of guidelines for multimorbidity; and prescribing culture. These factors collectively increase the risk of medication related problems, treatment conflicts and poor treatment outcomes.

The management of medication in people with dementia requires the increasing involvement of pharmacists to provide a number of cognitive services including medication reconciliation, medication review, adherence services and proactive adverse reaction monitoring. This needs to be integrated into a multidisciplinary, patient-centered, integrated and coordinated model of care to improve QUM and health outcomes for people with dementia.

About the presenter

Associate Professor Tuan Anh Nguyen is a Principal Research Fellow at NARI and an Associate Research Professor at School of Health Sciences, Swinburne University of Technology. He is also an Adjunct Associate Research Professor at Clinical and Health Sciences, University of South Australia. His current research lies on the development and implementation of national dementia strategies with a focus on low- and middle-income countries (LMICs), culturally tailored interventions to improve lives of people with dementia and their carers, and medicines that can induce or worsen cognitive impairment and dementia. His expertise covers broad areas, including pharmaceutical policy, pharmaco-epidemiology and drug safety, health care management, public health and behavioural sciences.

Associate Professor Nguyen is the founder and leader of a large dementia research collaborative in the Asia Pacific region, and the Principal Investigator on a number of competitive research grants, including three international grants to develop Vietnam’s National dementia plan, to build capacity for the next generation of Vietnamese dementia researchers, and to develop and test an iSupport Virtual Assistant to empower dementia carers in Australia, New Zealand, Indonesia and Vietnam. He has authored over 70 publications, 47 conference presentations and has attracted more than $11 million in research funding.

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