medication

Development and application of medication appropriateness indicators for persons with advanced dementia; A feasibility study

Parsons, C., McCann, L., Passmore, P. and Hughes, C.
Drugs and Aging
2016
The aim of this study by Parsons et al. (2016) was to categorise the appropriateness of a comprehensive list of medications and medication classes for use in patients with advanced dementia.
It also examined the feasibility of undertaking a longitudinal prospective cohort study to collect clinical and medication use data. Using the categories developed, it aimed to determine the appropriateness of prescribing for nursing home residents with advanced dementia in NI. The study involved a Delphi Consensus study, a longitudinal prospective cohort feasibility study and the retrospective application of appropriateness ratings to medication data of residents with advanced dementia. Consensus on appropriateness was achieved for 87 of the 97 medications and medication classes included in the survey. At baseline, the average number of medications prescribed to nursing home residents was 16.2, approximately a quarter of which were considered by the expert panel to be never appropriate. All but one of the 15 residents participating had been prescribed at least one of these medications, and this did not change significantly over the course of the study. The study demonstrates that it is feasible to collect clinical and medication use data from this cohort of people.

Briefing Paper on Dementia Diagnosis

Cahill and Pierce
Genio
2014

This briefing paper by Cahill and Pierce (2014) was commissioned by Genio Ltd in advance of the publication In ROI of the Irish National Dementia Strategy.

It describes where and by whom people receive a diagnosis of dementia, provides information on common standardised instruments used in cognitive assessment, the diagnostic criteria recommended for use, the value of neuropsychological testing and current thinking about best practice on disclosure patterns. It gives an overview of approaches to dementia diagnosis in five countries, namely England, France, the Netherlands, Norway and Australia. The final part of the paper identifies key actions for consideration in ROI to support the assessment and timely diagnosis of dementia. 

Mapping the Dementia Gap

CAHILL, S., Pierce, M
Genio
2011

Mapping the dementia gap produced by Tesco, Alzheimer's Society (UK) and Alzheimer Scotland puts figures on the gap between the number of people estimated to be living with dementia (both diagnosed and undiagnosed) across the UK, including NI, and the number that have received a diagnosis of deme

ntia based on the QoF dementia register. A fact sheet outlining dementia diagnosis rates specifically for NI in 2014 is available from the Alzheimer’s Society (UK) website. Equivalent figures are not available for ROI. 

A Comparison of People Seeking Help at Memory Clinics in Belfast and Dublin

Barrett, S., Savage, G.
CARDI
2012

Barrett and Savage (2012) examined socio-demographic and clinical differences in people diagnosed with Alzheimer disease (AD) and MCI attending two specialist memory clinics, one in Dublin and the other in Belfast, and where possible changes over time.

They also examined medications used by people diagnosed with AD and MCI in the memory clinics. The mean age of people receiving a diagnosis of AD in the Dublin clinic was 74, and was lower than the mean age of 78 recorded at the Belfast clinic. A greater proportion of women than men (3:1) received a probable diagnosis of AD in both memory clinics, but data from the Dublin clinic suggests that this gender difference may be narrowing. There were differences between the two memory clinics with respect to educational attainment with a higher proportion of people diagnosed with AD in the Belfast clinic with primary educational only, an indication perhaps that the Dublin clinic attracts people from higher social-economic groups. 

Unlocking Diagnosis: The Key to Improving the Lives of People with Dementia

Alzheimer’s Society
All Party Parliamentary Group
2012

This inquiry by the All-Party Parliamentary Group on Dementia covers all parts of the UK, including NI. Evidence for the inquiry was gathered from people with dementia, carers, family members, health professionals and other organisations and interested others, using a questionnaire.

The inquiry found a range of barriers to diagnosis that included poor public awareness; a need for GP training and problems with the Quality and Outcomes framework within which GPs operate; problems with current assessment tools; variability in memory services provision; and poor post-diagnostic support. Nine general recommendations are made with further specific suggestions for devolved health administrations. In the case of NI it was suggested that the awareness campaign referred to in the regional strategy could be prioritised; that the Health Minister could make a commitment on how data on diagnostic rates already available through the NHS Atlas of Variation could be used in monitoring the progress of the strategy; the Health and Social Care Board and the Public Health Agency could explore options to include questions to identify symptoms of dementia through regular interventions with the over-65s and others at higher risk of dementia.

Living With Dementia’: Implications for the National Dementia Strategy: Summary of Roundtable Discussions Submitted to the National Dementia Strategy Working Group

Alzheimer’s Society
Alzheimer Society of Ireland
2013

The fourth Alzheimer Society of Ireland publication reports on two roundtable discussions organised by the Alzheimer Society of Ireland, which provided an opportunity for the National Dementia Strategy Working Group and Department of Health officials to meet with people with dementia and carers a

nd get their input on priority areas earmarked for inclusion in the strategy. The roundtables were structured around three themes: the role of the GP; community services; and dementia awareness and education. The report summarises the discussions points and key messages under each heading. 

Multidisciplinary Clinicians Roundtable on the National Dementia Strategy

Alzheimer’s Society
Alzheimer Society of Ireland
2013

The third Alzheimer Society of Ireland publication is a report summarising a roundtable discussion involving healthcare professionals from multidisciplinary backgrounds including occupational therapy, social work, physiotherapy, speech and language therapy and nursing.

The themes used to structure the roundtable discussion were grounded in each of the five disciplinary areas: non-pharmacological interventions and behaviours that challenge (occupational therapy); improving Communication (speech and language therapy); physical activity for health and wellbeing (physiotherapy); A Social Work Perspective (social work); and the registered nurse’s contribution to person centred care (nursing).  As with the previous roundtable discussion, the report concludes with a set of suggestions as to how multidisciplinary clinicians can influence the development of the Irish National Dementia Strategy.  

Clinicians’ Roundtable on the National Dementia Strategy ReportClinicians’ Roundtable on the National Dementia Strategy Report

Alzheimer’s Society
Alzheimer Society of Ireland
2013

The second Alzheimer Society of Ireland publication is a report summarising a roundtable discussion involving health care professionals from the four areas of Old Age Psychiatry, Geriatric Medicine, Neurology and Psychology.

Facilitated by the Alzheimer Society of Ireland, the roundtable discussion brought together participants to share their expertise and discuss core clinical elements of the upcoming Irish National Dementia Strategy. The discussion centred on three key themes: Clinical Leadership and Developing a Dementia Register; People with Younger Onset Dementia; and Early Diagnosis and Memory Clinics/Services. A set of further actions needed to move the issues discussed forward is also included. 

National Strategy on Dementia: Summary of Consultation Process

Department of Health
Department of Health
2012

Following the assembly of the evidence into the research review described above, the Department of Health embarked on a public consultation process which commenced on 4 July and concluded on 31 August 2012.

The Department of Health invited submissions and used the research review as a basis for developing a questionnaire used in its public consultation. It received 73 responses and the core messages contained in the submissions and completed questionnaires are summarised in this report.  

A National Dementia Strategy for Ireland: Signposting the Possibilities: A Clinician’s Perspective

O’Connell. H.
Alzheimer Society of Ireland
2012

This first of four publications in this section from the Alzheimer Society of Ireland is written by O’Connell (2012) who outlines key directions from the clinician’s perspective to be taken in ROI’s National Dementia Strategy including an emphasis on prevention, early diagnosis and access to the

best available treatments. He acknowledges that people with dementia may have different priorities to clinicians and healthcare professionals and that it is important that the voice of the person with dementia is heard. Following a brief review of national dementia strategies in other countries, O’Connell outlines what he believes should be included in the Irish National Dementia Strategy. 

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