The role of the pharmacist should be made known to our patients and the community.
Written with Morgan Lee PharmD Candidate 2018 Harrison School of Pharmacy Auburn University
June is Alzheimer’s Disease (AD) and Brain Awareness Month. Every year, pharmacists help more than 5.4 million patients with AD and over 15 million of their caregivers.1
Pharmacists research questions for patients and families, identify resources for caregivers, and develop medication management solutions for patients. Pharmacists, especially in the community setting, see patients regularly, and as a result, they develop relationships with their patients and may be among the first to notice the sometimes subtle changes or signs of AD such as difficulty retaining new information or instructions, difficulty communicating, or changes in personality or behavior.2,4,6
The amount of education dedicated to AD recognition and medication management in pharmacy training has grown in recent years. Pharmacists are taught to evaluate patients’ mental status using the preferred cognitive exams, and the most up-to-date diagnostic criteria.5
Pharmacists have a firm familiarity with the medications that should be started upon early signs and diagnosis of AD and the recommendations from current treatment guidelines for adjusting medications as the disease progresses. Pharmacists ability to manage patients’ medications includes side effects, prevention and management, adherence assurance, and selection of the best dosage forms for our patients.4
Pharmacists are often the last step in the important process of medication counseling and have an important responsibility to educate patients and caregivers on any information or instructions about and what to expect from their medication. For example, one important counseling point involves adherence. If more than a couple of doses are missed, patients need to have their dose reduced to the starting dose of 5 mg and titrated back to prevent the drug’s untoward effects.6 Another counseling point involves donepezil. Patients should be counseled on how to deal with any gastrointesinal adverse effects that may arise, especially in the first few weeks and advise patients to take their dose right before bedtime to ease the consequences of these and other side effects.3,6
Pharmacists’ vast knowledge of drug interactions can also ensure that patients get the most out of their medications without introducing preventable and unnecessary complications. Pharmacists help evaluate medication efficacy and safety throughout treatment. At patient encounter, pharmacists may ask patients important questions to ensure that medications are working appropriately, and without intolerable effects. If issues are identified, pharmacists work with physicians to come up with safer or more effective medication regimens.4
Patients and their families should be aware that their pharmacists are trained to help them understand how to cope and adapt to new lifestyles that AD may require. They have access to information and resources on support groups for families as well as signs families should watch for signaling disease progression.4,7 It is so important for the AD community to know that their pharmacists are there for them, in all of these ways mentioned and many more. It is our job as pharmacists, to help get that word out.
The Clinical Focus condition center at NeurologyLive, Pharmacy Times' new sister site, provides further coverage from the Alzheimer’s disease space, as well as updates pertaining to dementia and the most recently released data from the field’s most prominent conferences.
1. C.A.R.E. Pharmacy Award. (n.d.). Retrieved from http://www.alz.org/living_with_alzheimers_16819.asp
2. 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved from http://www.alz.org/10-signs-symptoms-alzheimers-dementia.asp
3. Terrie, YC. (2007 January 1). The pharmacist's role in the management of Alzheimer's Disease [web]. Retrieved from http://www.pharmacytimes.com/publications/issue/2007/2007-01/2007-01-6235
4. Sederstrom, J. (2017 January 18). Alzheimer's Disease: Untapped Potential for Pharmacy [web]. Retrieved from http://drugtopics.modernmedicine.com/drug-topics/news/alzheimers-disease-untapped-potential-pharmacy
5. Tests for Alzheimer's Disease and Dementia. (n.d.). Retrieved from http://www.alz.org/alzheimers_disease_steps_to_diagnosis.asp
6. Alzheimer's Disease Medications Fact Sheet. (2016 August 30). Retrieved from https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet#table
7. Alzheimer's and Dementia Resources for Professionals. (n.d.). Retrieved from https://www.nia.nih.gov/alzheimers/alzheimers-and-dementia-resources-professionals#patient-education