Risvoll Hilde, Giverhaug Trude, Halvorsen Kjell H, Waaseth Marit, Musial Frauke
, NKS Kløveråsen AS, Junkernveien 67, 8076, Bodø, Norway.
RELIS North Norway, University Hospital North Norway, Sykehusvegen 38, 9019, Tromsø, Norway.
BMC Complement Altern Med. 2017 May 12;17(1):261. doi: 10.1186/s12906-017-1765-5.
The use of dietary supplements (DS) is common among persons with dementia. Direct risks associated with DS use include adverse events and DS-drug interactions. A direct risk is a risk caused by the treatment itself. Indirect risks are related to the treatment setting, such as the conditions of use, and not to the treatment itself. Because dementia symptoms may reduce a person's ability to cope with the administration of DS, the use of DS may pose a threat to safety as an indirect risk. The aim of this study was to describe the extent of DS use among persons with dementia in ambulatory care and to identify some relevant direct and indirect risks related to DS use.
We conducted a survey among 151 persons with dementia attending an outpatient memory clinic in Northern Norway. Study measurements included: the participants' characteristics, cognitive functioning, functioning in the activities of daily living (ADL), and the use of DS and prescription drugs (PD). We assessed direct risks by evaluating potential DS-drug interactions and indirect risks by evaluating the conditions under which it was used.
Forty-six percent (n = 70) of the persons with dementia used DS. Ninety-seven percent (n = 147) used PD. We found potentially clinically relevant DS-drug interactions representing a direct risk in eight persons with dementia (11% of users). While only 36% (n = 26) of the participants received assistance with the administration of DS, 73% (n = 106) received assistance with the administration of PD. Persons with dementia living alone were at risk of not receiving assistance, as home care service seldom was involved in DS administration. Data indicated that assistance with DS administration was not provided for all persons with dementia in need, representing an indirect risk to these persons. Only one-third of the persons with dementia and half of the caregivers were aware of the general risks of adverse events and interactions associated with the use of DS.
Persons with dementia use DS frequently, yet DS use may be associated with direct and indirect risks to patient safety as potentially clinically relevant interactions were discovered and DS intake often was unsupervised.
膳食补充剂（DS）在痴呆症患者中使用很普遍。与使用DS相关的直接风险包括不良事件和DS与药物的相互作用。直接风险是由治疗本身引起的风险。间接风险与治疗环境有关，例如使用条件，而不是与治疗本身有关。由于痴呆症状可能会降低患者应对DS服用的能力，因此DS的使用作为间接风险可能对安全构成威胁。本研究的目的是描述门诊护理中痴呆症患者使用DS的程度，并确定一些与DS使用相关的直接和间接风险。
我们对挪威北部一家门诊记忆诊所的151名痴呆症患者进行了调查。研究测量包括：参与者的特征、认知功能、日常生活活动（ADL）功能，以及DS和处方药（PD）的使用情况。我们通过评估潜在的DS与药物相互作用来评估直接风险，并通过评估使用DS的条件来评估间接风险。
46%（n = 70）的痴呆症患者使用DS。97%（n = 147）的患者使用PD。我们在8名痴呆症患者（占使用者的11%）中发现了具有潜在临床相关性的DS与药物相互作用，这代表了直接风险。虽然只有36%（n = 26）的参与者在服用DS时得到了帮助，但73%（n = 106）的参与者在服用PD时得到了帮助。独居的痴呆症患者有得不到帮助的风险，因为家庭护理服务很少参与DS的给药。数据表明，并非所有有需要的痴呆症患者都能得到DS给药方面的帮助，这对这些患者来说是一种间接风险。只有三分之一的痴呆症患者和一半的护理人员了解与使用DS相关的不良事件和相互作用的一般风险。
痴呆症患者经常使用DS，但由于发现了潜在的临床相关相互作用且DS的摄入往往无人监督，DS的使用可能对患者安全产生直接和间接风险。
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