Alzheimer Disease Clinical Trial
Official title:
Evaluation of the Impact of Personalized Pharmaceutical Collaborative Care Integrated to a Multidisciplinary Psychosocial Program on the Burden Felt by Caregivers of Elderly Patients With Alzheimer's Disease and Related Disorders and Evaluated at 18-month Follow-up
Caring for patients with Alzheimer Disease or Related Disorders (ADRD) is accompanied with a
caregiver burden that increases with the progression of the disease. This burden can have
physical, psychological, emotional, social and financial issue on the informal caregivers who
are often represented as hidden secondary patients. They frequently have a higher risk of
developing mood disorders as depression, anxiety, stress, sleep disorders and a lower quality
of life associated with a greater use of psychotropic drugs. They also incur higher risk of
heart disease and mortality. The embrittlement of the caregiver is a major factor of early
institutionalization of patient. In the PIXEL study, the mean age of the men caregivers was
73.9 years and 64.8 for the women caregivers. Elderly themselves, especially spouses, the
informal caregivers are also exposed to common chronic diseases and associated polypharmacy
with a higher risk of developing drug-related problems due to aging and negligence of their
own health care. These risks are increased mainly in the elderly because of changes in
pharmacokinetic and pharmacodynamic parameters related to aging, acute or chronic diseases
and the potentially inappropriate prescription (PIP). Previous studies have shown the
effectiveness and positive impact of optimization of the therapeutics by a clinical
pharmacist on the reduction of drug-related problems, length of hospital stay, readmission
rates, quality of life and mortality. The patient's medication management is usually
delegated to the informal caregiver, who must also manage his own treatment. The caregiver
may face difficulties with therapeutics (e.g., inappropriate dosage form, adverse effects and
patient refusal) that could impact on its compliance with treatment or that of his relative.
No previous study has evaluated the impact of pharmaceutical collaborative care including
personalized interview with a clinical pharmacist and optimization of drug prescribing among
patients with ADRD and their caregivers.
However, many studies have assessed the effectiveness of non-pharmacological interventions on
caregiver burden, mood disorders and the patient institutionalization. Meta-analysis showed a
moderate improvement of the caregiver burden.
The main objective of the PHARMAID study is to measure the impact of personalized
pharmaceutical collaborative care integrated to a multidisciplinary psychosocial program on
the burden of ADRD caregivers and assessed at 18-month follow-up.
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