[Pharmaceutical care for patients and their caregivers in Alzheimer's disease and related disorders: a review and new perspectives]

Abstract

Many arguments support the development of pharmaceutical care in patients with neurocognitive disorders and their caregivers: polypharmacy, drug-related cognitive decline, poor drug adherence, increased use of psychotropic drugs and potentially inappropriate medications. The aim of this narrative review was to identify the pharmacist's roles in caring for patients with Alzheimer's disease and related disorders and their caregivers. Seventeen publications were selected after literature research. The various interventions conducted by pharmacists were as follows: achievement of a medication review that could be focused on the reduction of the anticholinergic burden or the number of psychotropic drugs, therapeutic education of the patient and his caregiver concerning the treatment management, personalized pharmaceutical follow-up, screening and orientation of patients with a cognitive impairment or caregivers with signs of fragility (burden, anxiety or depressive symptoms). The majority of studies targeted the patient care. Other interventional studies will be necessary to evaluate the impact of a pharmaceutical care for the dyad, including the caregiver, on the improvement of drug management but also on clinical outcomes, including the cognitive function, the autonomy, the use of the health care system, the quality of life and the self-efficacy.

Keywords: Alzheimer's disease; caregiver; pharmaceutical care; pharmacist; review.