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社区药剂师对多奈哌齐不良反应及阿尔茨海默病患者失眠自我护理建议的了解

Community Pharmacists' Knowledge Regarding Donepezil Averse Effects and Self-Care Recommendations for Insomnia for Persons with AD.

作者信息

Marvanova Marketa, Henkel Paul Jacob

机构信息

Department of Pharmacy Practice, School of Pharmacy/College of Health Professions, North Dakota State University, Department 2650, P.O. Box 6050, Fargo, ND 58108-6050, USA.

Department of Geographical and Historical Studies, University of Eastern Finland, FI-80101 Joensuu, Finland.

出版信息

Pharmacy (Basel). 2017 Jul 28;5(3):42. doi: 10.3390/pharmacy5030042.

Abstract

Alzheimer's disease (AD) impacts millions of individuals worldwide. Since no cure is currently available, acetylcholinesterase inhibitors are symptomatic therapy. This study assessed community pharmacists' knowledge regarding donepezil adverse effects (AEs) and self-care recommendations for insomnia management for persons with AD treated with rivastigmine. This is a cross-sectional, standardized telephone survey of community pharmacists ( = 862) in three study areas: West Virginia, North Dakota/South Dakota, and Southern Oregon/Northern California. Pharmacists' degree, sex, and pharmacists' AD-related knowledge were assessed. In-stock availability of donepezil and rivastigmine formulations was assessed. Analyses were performed using Stata 10.1. Only 31.4% pharmacists were able to name ≥2 donepezil AEs. Only four donepezil AEs were named by at least 13% of pharmacists: nausea (36.1%), dizziness (25.1%), diarrhea (15.0%), and vomiting (13.9%). All other AEs were named by fewer than 7% of respondents. Only 62.9% of pharmacists ( = 542) provided appropriate recommendations: melatonin (40.3%), referral to physician (22.0%), or sleep hygiene (0.6%). Over 12% of pharmacists ( = 107) provided inappropriate recommendations (anticholinergic agent or valerian root) and 21.5% of pharmacists were unable to provide any recommendation. We identified significant gaps in community pharmacists' knowledge regarding donepezil AEs and non-prescription insomnia recommendation needing significant improvement to ensure high-quality AD-related care.

摘要

阿尔茨海默病(AD)影响着全球数百万人。由于目前尚无治愈方法,乙酰胆碱酯酶抑制剂属于对症治疗。本研究评估了社区药剂师关于多奈哌齐不良反应(AEs)的知识,以及对接受利伐斯的明治疗的AD患者失眠管理的自我护理建议。这是一项对西弗吉尼亚州、北达科他州/南达科他州以及俄勒冈州南部/加利福尼亚州北部三个研究地区的社区药剂师(n = 862)进行的横断面标准化电话调查。评估了药剂师的学位、性别以及与AD相关的知识。评估了多奈哌齐和利伐斯的明制剂的库存情况。使用Stata 10.1进行分析。只有31.4%的药剂师能够说出≥2种多奈哌齐的不良反应。至少13%的药剂师提到的多奈哌齐不良反应只有四种:恶心(36.1%)、头晕(25.1%)、腹泻(15.0%)和呕吐(13.9%)。所有其他不良反应被提及的比例不到7%。只有62.9%的药剂师(n = 542)提供了适当的建议:褪黑素(40.3%)、转诊给医生(22.0%)或睡眠卫生(0.6%)。超过12%的药剂师(n = 107)提供了不适当的建议(抗胆碱能药物或缬草根),21.5%的药剂师无法提供任何建议。我们发现社区药剂师关于多奈哌齐不良反应和非处方失眠建议方面存在重大差距,需要显著改进以确保高质量的AD相关护理。

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