EPA-1248 – Donepezil Prescribing Pattern in Dementia: An Audit From Gateshead memory service

Abstract

Introduction:

Donepezil is an acetylcholinesterase (AChE) inhibitor recommended as an option for managing mild to moderate Alzheimer's Disease (AD) by NICE (National Institute of Clinical Excellence) UK. Donepezil is generally well tolerated but it can have potential side effects, contraindications and drug interactions. It is essential that a risk-benefit analysis is carried out before prescribing.

Aims and Objectives:

The memory service in Gateshead uses an agreed pro-forma based on the Patient Group Directive (PGD) standard – for nurse led administration. It includes demographics, diagnosis, contraindications, hypersensitivity, drug interactions and side effects.

Our PGD also assesses capacity, pre and post Donepezil psychometric testing – including screening for other psychiatric symptoms and assessment of carer stress in order to provide a more comprehensive assessment of this patient group, facilitating improved care and if necessary referral/input from other services.

This audit looked at completion of this documentation in order to review current practice and identify any potential areas for improvement.

Methods:

20 patient records from May 2012-March 2013 were randomly selected and analysed using the data collection tool.

Results:

The analysis highlighted 100% documentation with regards to demographic details, side effect explanation and drug tolerance assessment. However, the documentation with regards to psychometric assessments and caregiver stress attained only 90%. The documentation of diagnosis and hypersensitivities was documented only in a minority of cases.

Conclusions:

Diagnosis, psychometric assessment including carer stress is essential in prognosis and monitoring treatment. Recommendation was made to review the areas for improvement and to do a re-audit.