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Master Thesis

Observation des pratiques d’évaluations des traitements par anticholinestérasiques et mémantine chez les patients atteints de maladies d'Alzheimer et apparentées dans les EHPAD en Sud-Landes

Abstract : Dementia associated with Alzheimer's disease and related diseases affects between 850,000 and 900,000 people in France. The medical service rendered by anticholinesterasic drugs and memantine was considered weak by the Trans-parency Commission of the HAS and is subject to an annual prescription reserved for physicians specializing in neurolo-gy, psychiatry or geriatrics. The main objective was to calculate the proportion of prescriptions of anticholinesterasic and / or memantine evaluat-ed annually. This is an observational cross-sectional study, carried out in patients residing in EHPAD in Sud-Landes. Sec-ondary objectives were to describe these ongoing drug prescriptions, to calculate the rate of patients with warning signs (centered on quality of life, adherence, and treatment tolerance) that could call into question their treatment’s relevance, evaluate the proportion of associated psychotropic treatments, and determine which doctors conduct these therapeutic reassessments. In the 128 patients enrolled, 74 were treated with cholinesterase inhibitors, 53 with memantine, and one was under dual therapy. After subtracting the 5 patients undergoing a single assessment at their primoprescription, 25.20% had benefited from a revaluation in the previous year. The average duration of treatment was 3.5 years. For 25.00% of patients included, no reassessment was found. For 53.91% of patients, at least one of the warning signs was likely to call into question the relevance of the prescription. In 84,00 % of patients included, there was an associated prescription of at least one psychotropic agent, and 26.67% of patients treated with anticholinesterase an antipsychotic. Re-evaluations of these treatments were largely insufficient. Some tools could be used to assist in the regular assess-ments of various treatments in this population.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01492037
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, March 17, 2017 - 6:16:02 PM
Last modification on : Wednesday, August 23, 2017 - 4:41:35 PM
Long-term archiving on: : Sunday, June 18, 2017 - 1:41:37 PM

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  • HAL Id : dumas-01492037, version 1

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Nadège Fone Tchoura. Observation des pratiques d’évaluations des traitements par anticholinestérasiques et mémantine chez les patients atteints de maladies d'Alzheimer et apparentées dans les EHPAD en Sud-Landes. Médecine humaine et pathologie. 2017. ⟨dumas-01492037⟩

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