Many with Advanced Dementia Receiving Drugs of Uncertain Benefit

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Medications of questionable benefit (MQBs) are those that have limited benefit, are associated with unnecessary risks, or both, are never appropriate at the end of life.  This medication group formed the base of a Journal of the American Geriatrics Society study conducted by an expert panel of geriatricians. Examples of MQBs include lipid-lowering agents, antiplatelet agents excluding aspirin, anti-dementia drugs, sex hormones, hormone antagonists, leukotriene inhibitors, cytotoxic chemotherapy agents, and immune modulators.  The records of nearly 9300 Ontario nursing home residents, aged 66 years and older, with a diagnosis of dementia who died between 6/1/10 and 3/31/13 were studied.  They found that 86.3% received at least one MQB in the last 120 days of life, 65.9% in the last 2 weeks and 45% in the last week. This article highlights the importance of taking steps to discontinue non-beneficial medications during the final weeks and months of life.

 

Links to Medscape article (4/2017) and J Am Geriatrics Soc abstract (3/2017)

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