Direct and indirect risk associated with the use of dietary supplements among persons with dementia in a Norwegian memory clinic

BMC Complementary and Alternative Medicine

Research Article

Kjell H. Halvorsen¹  Marit Waaseth¹  Frauke Musial²  Hilde Risvoll³  Trude Giverhaug⁴ 

[1] Department of Pharmacy, UiT The Arctic University of Norway, pb 6050 Langnes, 9037, Tromsø, Norway;NAFKAM, UiT The Arctic University of Norway, pb 6050 Langnes, 9037, Tromsø, Norway;NKS Kløveråsen AS, Junkernveien 67, 8076, Bodø, Norway;RELIS North Norway, University Hospital North Norway, Sykehusvegen 38, 9019, Tromsø, Norway;RELIS North Norway, University Hospital North Norway, Sykehusvegen 38, 9019, Tromsø, Norway;

关键词: Patient safety;    Dementia;    Dietary supplements;    Risk management;    Direct risk;    Indirect risk;    Drug interactions;    Caregivers;    Home care services;    Cross-sectional survey;   

DOI  :  10.1186/s12906-017-1765-5

 received in 2016-07-05, accepted in 2017-04-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsWe 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.ResultsForty-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.ConclusionsPersons 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.

【 授权许可】

CC BY   
© The Author(s). 2017