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Donepezil use in US nursing homes
Claudio Pedone1, Kate L Lapane, Vince Mor
1Centro di Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Roma, Italy. claudio_pedone@rm.unicatt.it
Aging Clinical and Experimental Research
|May 11, 2004
Summary
Donepezil is commonly prescribed for Alzheimer's disease (AD) in nursing homes. Off-label use is frequent, potentially for behavioral issues, though evidence is limited.
Area of Science:
- Gerontology
- Pharmacology
- Neurology
Background:
- Donepezil is a key medication for slowing Alzheimer's disease (AD) progression.
- Limited data exists on donepezil utilization patterns within nursing home populations.
- Understanding usage is crucial for optimizing care in long-term facilities.
Purpose of the Study:
- To determine the prevalence and initiation patterns of donepezil use in nursing home residents.
- To characterize demographic and clinical factors associated with donepezil prescription.
- To investigate donepezil use in relation to AD diagnosis and behavioral symptoms.
Main Methods:
- Analysis of a large dataset (N=174659) from the Minimum Data Set.
- Comparison of donepezil users and non-users based on clinical and functional variables.
- Stratified analysis by resident status (newly admitted vs. long-stay) and 6-month follow-up.
Main Results:
- Prevalence of donepezil use was 30% (newly admitted) and 19% (long-stay) for mild to moderate AD.
- Approximately 3% of residents without an AD diagnosis were prescribed donepezil (off-label use).
- Donepezil use correlated with cognitive impairment, behavioral problems, and psychotropic medication use.
Conclusions:
- Donepezil is widely used in nursing homes for Alzheimer's disease management.
- Off-label donepezil prescription is common, possibly for managing behavioral symptoms.
- Further research is needed to validate the effectiveness of donepezil for non-cognitive outcomes.