Home' Australian Pharmacist : Australian Pharmacist February 2015 Contents Australian Pharmacist February 2015 I ©Pharmaceutical Society of Australia Ltd.
1. Which ONE of the following
statements regarding dementia is
the LEAST appropriate?
a) Dementia may occur in people less than
65 years of age.
b) The prevalence of dementia is
increasing in Australia.
c) The majority of Australians with dementia
live in residential aged care facilities.
d) Polypharmacy is common in people
2. Which ONE of the following is LEAST
likely to be considered a characteristic
of a dementia-friendly pharmacy?
a) Training of a single staff ‘champion’ in
communication techniques for people
b) Streamlined processes and simplified
documentation wherever possible.
c) Ongoing evaluation of all strategies
implemented to improve dementia-
d) Environmental audit of signage,
lighting and colour contrast to ensure
appropriateness for people with dementia.
3. Which ONE of the following
statements regarding medication
use in people with dementia is the
a) Most adherence issues can be resolved
with only the introduction of a dose
administration aid (DAA).
b) Transitions between care sites are
a particularly high risk period for
c) Non-adherence is rarely an issue for
people with dementia.
d) People with dementia are generally at no
greater risk of medication misadventure
than the greater population.
4. Which ONE of the following
statements regarding sedative use
for the management of behavioural
and psychological symptoms of
dementia (BPSD) is the LEAST
a) There is evidence that many people
with dementia are prescribed
benzodiazepines for much longer
periods than guidelines recommend.
b) When used for BPSD, antipsychotics
are associated with an increased risk of
cerebrovascular accidents and death.
c) Antipsychotics will improve most BPSD
for a majority of people with dementia if
given for a sufficient length of time.
d) Educational interventions delivered by
pharmacists to RACF staff have been
found to significantly reduce sedative
use for BPSD.
5. As the manager of a community
pharmacy, you decide that the
business should work towards
becoming more dementia-friendly
and increase its services to support
people living with dementia. You
create an action plan based on
the Alzheimer’s Australia business
toolkit, and start promoting a range
of adherence assistance strategies,
MedsChecks and clinical medication
management reviews (HMRs and
RMMRs). However, a local GP asks a
number of questions about the need
for these services and whether there
is any evidence that pharmacists can
support people living with dementia.
Which ONE of the following
responses is the LEAST appropriate?
a) Whilst there is evidence that most
medications of questionable benefit are
ceased in advanced dementia, RMMRs
improve adherence with remaining
b) HMRs have been shown to significantly
reduce the burden of medications with
anticholinergic and sedative effects in
people who receive the service.
c) MedsChecks provide an ideal
opportunity to identify and address
medication management issues
that people with dementia may be
d) Current RMMR guidelines specifically
reference people with altered cognitive
function as being likely to benefit from
Australia; 2014. At: https://act.fightdementia.org.au/sites/
9. Smith F, Grijseels MS, Ryan P, Tobiansky R. Assisting people
with dementia with their medicines: experiences of family
carers. Int J Pharm Prac 2014. DOI: 10.1111/ijpp.12158. (Epub
ahead of print)
10. Alzheimer’s Australia. Dementia-friendly toolkits. Canberra:
Alzheimer’s Australia. 2014. At: https://fightdementia.org.au/
11. While C, Duane F, Beanland C, et al. Medication
management: the perspectives of people with dementia and
family carers. Dementia 2013;12(6):734–50.
12. Luzny J, Ivanova K, Jurickova L. Non-adherence in seniors
with dementia – a serious problem of routine clinical
practice. Acta medica (Hradec Kralove) 2014;57(2):73–7 .
13. Arlt S, Lindner R, Rösler A, von Renteln-Kruse W. Adherence
to medication in patients with dementia. Drugs Aging
14. Pharmacy Guild of Australia. Programme Specific Guidelines
MedsCheck and Diabetes MedsCheck. Canberra: PGA; 2014.
15. Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral
and psychological symptoms of dementia. Front Neurol
16. Corbett A, Burns A, Ballard C. Don’t use antipsychotics
routinely to treat agitation and aggression in people with
dementia. Br Med J 2014;349.
17. Westbury J, Jackson S, Peterson G. Psycholeptic use in
aged care homes in Tasmania, Australia. J Clin Pharm Ther
18. Ballard C, Gauthier S, Corbett A, et al. Alzheimer’s disease.
19. Rhee Y, Csernansky JG, Emanuel LL, et al. Psychotropic
medication burden and factors associated with antipsychotic
use: an analysis of a population-based sample of community-
dwelling older persons with dementia. J Am Geri Soc
20. Banerjee S. The use of antipsychotic medication for people
with dementia: Time for action. United Kingdom: Department
of Health; 2009. At: www.psychrights.org/Research/Digest/
21. International Psychogeriatric Association. The IPA Complete
Guides to BPSD – module 6: pharmacological management.
Northfield, IL, United States: IPA; 2012. At: www.ipa-online.
org/members/pdfs/____IPA _BPSD_Module_6 .pdf
22. Richter T, Meyer G, Möhler R, et al. Psychosocial interventions
for reducing antipsychotic medication in care home
residents. Cochrane Database of Systematic Reviews 2012,
Issue 12. Art. No.: CD008634. DOI: 10.1002/14651858.
23. Westbury J, Jackson S, Gee P, et al. An effective approach to
decrease antipsychotic and benzodiazepine use in nursing
homes: the RedUSe project. Int Psychoger 2010;22(1):26–36 .
24. NPS Medicinewise. New reporting mechanism for
antipsychotic use in aged care. 2013. At: www.nps.org.au/
25. Yeh YC, Liu CL, Peng LN, et al. Potential benefits of reducing
medication-related anticholinergic burden for demented
older adults: a prospective cohort study. Ger Gerontol Int
26. Gnjidic D, Hilmer SN, Hartikainen S, et al. Impact of high risk
drug use on hospitalization and mortality in older people
with and without Alzheimer’s Disease: a national population
cohort study. PLoS ONE 2014;9(1):e83224.
27. Kersten H, Molden E, Tolo IK, et al. Cognitive effects of
reducing anticholinergic drug burden in a frail elderly
population: a randomized controlled trial. J Gerontol
28. Castelino RL, Hilmer SN, Bajorek BV, et al. Drug Burden Index
and potentially inappropriate medications in community-
dwelling older people: the impact of Home Medicines
Review. Drugs Aging 2010;27(2):135–48.
29. Nishtala P, Hilmer S, McLachlan A, et al. Impact of residential
medication management reviews on Drug Burden Index in
aged-care homes. Drugs Aging 2009;26(8):677–86 .
30. Pharmaceutical Society of Australia. Guidelines for
pharmacists – domicillary medication management review.
Canberra: PSA; 2000. At: www.psa.org.au/supporting-
31. Pharmacy Guild of Australia. Programme Specific Guidelines
Home Medicines Review (HMR). Canberra: PGA; 2014.
32. Pharmacy Guild of Australia. Programme Specific Guidelines
Residential Medication Management Review Programme
(RMMR) and Quality Use of Medicines Programme (QUM).
Canberra: PGA; 2014. At: http://5cpa.com.au/files/rmmr-and-
33. Luchins DJ, Hanrahan P. What is appropriate health care for
end-stage dementia? J Am Geriatr Soc 1993;41(1):25–30.
34. Tjia J, Briesacher BA, Peterson D, et al. Use of medications of
questionable benefit in advanced dementia. JAMA Internal
Medicine 2014;174(11):1763–71 .
35. Pharmaceutical Society of Australia. Guidelines for
pharmacists providing Residential Medication Management
Review (RMMR) and Quality Use of Medicines (QUM)
services. Canberra: PSA; 2011. At: http://www.psa.org.au/
Links Archive Australian Pharmacist January 2015 Australian Pharmacist March 2015 Navigation Previous Page Next Page