Why: Most people living with dementia have at least one other health condition. They often use medications to manage their other health conditions, but we don’t have much information to guide us on whether this is appropriate. Information to help us optimise medication use for older adults generally are helpful, but people living with dementia have specific needs as they are living with a progressive life-limiting condition.
How: As there is little research to base decisions on, we recruited experts. We had 57 pharmacists, doctors, nurse practitioners, psychologist and a patient advocate from around Australia agree to participate in the research. The research used the Delphi method to develop consensus, which involved three rounds of surveys. We asked them open-ended questions about their roles and experience in managing medications for people with dementia. This data was analysed, and turned in to statements. The participants were asked in the second round and third round statements about their agreement with the questions. This agreement was rated on a 5-point Likert-scale. The statements that we reached consensus on have then been included in the Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria.
So what: The experts reached consensus on 111 of 128 statements. The statements were in the broad themes of preventative medication, symptom management, disease progression, psycho-active medication, treatment goals, principles of medication use, side effects, and medication reviews. The experts emphasised the need for each person to be treated as an individual and for their therapy to match their own health goals. They have suggested areas where appropriate therapy changes as dementia progresses from the early to the mid to the late stages. This research provides consensus-based guidance for clinicians who manage comorbid health conditions in people with dementia.