Effects of Prescription Drug Reduction on Quality of Life in Community Dwelling Patients with Dementia

Due to the rapid aging of Japanese society, community-dwelling medical care has become a social necessity. In this study, researchers focused on patients over 65 years of age with dementia. Approximately 4.62 million Japanese elders over the age of 65 suffer from dementia, and the morbidity rate associated with dementia is 15%. The goal of these researchers is to find methods that allow elderly people, including dementia patients to lead high-quality lives.

Community-dwelling medical care consists primarily of drug therapy. Thus, problems associated with polypharmacy are expected to increase. The use of multiple drugs and diminished cognitive function may cause the elderly to experience problems using drugs appropriately. Patients with six or more drugs have been reported to show a higher incidence of adverse drug reactions than other patients. Japanese researchers decided to study whether drug reduction in community-dwelling dementia patients would change the quality of life and the activities of daily living three to six months after the drug reduction.

Researchers studied 50 community-dwelling patients ages 65 or older, and the number of prescription drugs taken by each patient was reduced by an average of 2.6. In the intervention group with reduction in medications, researchers found that the scores associated with quality of life remained stable and scores related with activities of daily living slightly increased. There were also significant increases in items related to activities of daily living, such as transferring to bed, walking, and bladder control. However, there were worsened scores for anxiety/depression questions. This may have been due to the reduction of use of benzodiazepines.

Since there were results that were associated with an increase in activities of daily life, I believe that it would be a good idea to conduct more research on drug reduction. It would be interesting to see if other studies had stronger evidence about the benefits of drug reduction. In addition, I think it would be a good idea to learn about when drug reduction may be appropriate in a clinical setting. What is your opinion about drug reduction? Do you believe that this is an important topic that must be researched?

Sakakibara M, Igarashi A, Yoshimasa T et al. Effects of Prescription Drug Reduction on Quality of Life in Community-Dwelling Patients with Dementia. J Pharm Pharm Sci. 2016;18(5): 705-712