Medication Safety, Adherence, and Deprescribing in Patients With Dementia

Patients with dementia face challenges with medication adherence because of the nature of the disease. Not only is adherence difficult in individuals with dementia, but the majority of this patient population also has comorbidities that make comprehension of complex treatment plans difficult. A large analysis of patients with dementia showed that 12% had only dementia as a diagnosis, 70% had at least two comorbidities, and 48% had at least three comorbidities. Proper medication adherence is important to prevent progression of these comorbidities and decline in overall health. However, as dementia progresses, the risk of taking certain medications may outweigh the benefits. Therefore, the treatment team needs to reassess medication lists over time. Incorrect medication use can pose a major safety concern for this patient population. Pharmacists can have conversations with patients and the patients' family members to discuss goals of care to determine if deprescribing is an option.