UMASS STUDY QUESTIONS
More than half of patients with advanced dementia who are in the end stages of Alzheimer’s disease continue to receive drugs that have questionable benefits, such as medications to treat dementia and statins to lower their cholesterol levels, finds a new study from the University of Massachusetts Medical School in Worcester. Such treatments not only drive up medical costs but also put patients’ health at risk since many have a hard time swallowing pills or may be experiencing side effects, like nausea, muscle pain, or urinary retention, that they can’t communicate to their healthcare providers.
“We were looking at people with very severe impairment,” said Dr. Jennifer Tjia, an associate professor of quantitative health sciences and medicine at University of Massachusetts Medical School. “They rarely recognize their family members and a minimal verbal ability of five words or less.”
Most of the patients can no longer walk. In the study published last Monday in JAMA Internal Medicine, Tjia and her colleagues examined medical records of 5,406 nursing home residents with advanced dementia in 460 facilities across the United States from 2009 to 2010. They found that nearly 54 percent received at least one medication that was of questionable benefit usually because their doctor had declined to take them off of it when their symptoms worsened over time.
“It’s much easier to start someone on a medication and keep them on than to take them off,” Tjia said. “It’s called clinical inertia.”