Preventative medication is defined as medication to prevent a future serious event or delay the progression of a comorbidity.
Expert consensus is that these practices are recommended in the care of people with dementia
Early Stage Dementia
When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:
-
functionality as the most important factor
-
the potential benefits weighed against the actual harm
-
potential for side effects
-
actual side effects
-
the risks of polypharmacy
-
the administration burden
-
maximise quality of life rather than prolong survival
- continue annual influenza vaccines indefinitely
Mid Stage Dementia
When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:
-
functionality as the most important factor
-
the potential benefits weighed against the actual harm
-
potential for side effects
-
actual side effects
-
the risks of polypharmacy
-
the administration burden
-
maximise quality of life rather than prolong survival
- continue annual influenza vaccines indefinitely
Late Stage Dementia
When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:
- functionality as the most important factor
- the potential benefits weighed against the actual harm
- potential for side effects
- actual side effects
- the risks of polypharmacy
- the administration burden
- maximise quality of life rather than prolong survival
- use less stringent targets for blood glucose
- only use diuretics for symptomatic management of heart failure
- cease antihypertensive agents
- cease lipid-lowering medications
- cease medications to manage osteoporosis
- cease anti-platelet, anti-coagulants and anti-thrombotic agents
- cease all medications that do not also provide tangible symptom relief
- cease medications that have a longer potential time to benefit than the person’s likely prognosis
Expert consensus is that these practices are NOT recommended in the care of people with dementia
Early Stage Dementia
When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:
- cease all medications that do not also provide tangible symptom relief
- cease anti-platelet, anti-coagulants and anti-thrombotic agents
- cease medications to manage osteoporosis
- cease antihypertensive agents
Mid Stage Dementia
When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:
- cease medications to manage osteoporosis
- cease antihypertensive agents