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Patient Preferences for Dementia Interventions: A Scoping Review With a Systematic Review of Medications and
Ravi Gupta1,2, Shanshan Lin1, Michael J DiStefano3
1Division of General Internal Medicine, Johns Hopkin School of Medicine, Baltimore, Maryland, USA.
Understanding patient preferences for Alzheimer's disease and related dementias (ADRD) treatments is crucial. Research shows patients value memory improvement and support, but more data is needed, especially for medications.
Area of Science:
- Gerontology
- Neuroscience
- Health Services Research
Background:
- Emerging treatments for Alzheimer's disease and related dementias (ADRD) exist.
- Patient preferences for ADRD care and treatment are not well understood.
Purpose of the Study:
- To review and synthesize existing literature on patient preferences for dementia treatment and care interventions.
- To identify gaps in understanding patient preferences, particularly regarding medications.
Main Methods:
- Systematic literature search of PubMed, PsycINFO, CINAHL, and EMBASE up to November 12, 2024.
- Synthesis of findings from studies using choice-based preference elicitation and medication preference assessments.
- Included 82 studies published between 1996 and 2024, evaluating primarily non-pharmacological interventions.
Main Results:
- Patients with cognitive impairment highly value memory improvement and emotional/social support.
- Most studies focused on non-pharmacological interventions, with limited research on medication preferences.
- Data on patient preferences were heterogeneous across the included studies.
Conclusions:
- Significant gaps exist in the literature regarding treatment preferences, especially for medications, in older adults with cognitive impairment.
- Further research is needed to develop validated clinical tools for preference elicitation.
- Aligning interventions with patient values requires better methods for understanding and incorporating preferences.
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