An Evaluation of Community Pharmacists' Knowledge and Experience regarding Dementia with Lewy Bodies:

Keiko Goto; Fumiha Kawachi; Shihoko Nakano; Kazuma Yoshimura; Kenichi Negishi; Takehisa Hanawa; Katsuyoshi Mizukami

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An Evaluation of Community Pharmacists' Knowledge and Experience regarding Dementia with Lewy Bodies:

VernacularTitle:An Evaluation of Community Pharmacists' Knowledge and Experience regarding Dementia with Lewy Bodies: A Cross-Sectional Study in Japan
Author: Keiko GOTO ¹ ; Fumiha KAWACHI ¹ ; Shihoko NAKANO ¹ ; Kazuma YOSHIMURA ¹ ; Kenichi NEGISHI ¹ ; Takehisa HANAWA ¹ ; Katsuyoshi MIZUKAMI ²
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1. Faculty of Pharmaceutical Sciences, Tokyo University of Science
2. Graduate School of Comprehensive Human Sciences University of Tsukuba
Keywords: dementia with Lewy bodies; community pharmacist; early detection; drug hypersensitivity
From:Japanese Journal of Drug Informatics 2020;22(3):153-161
CountryJapan
Language:English
Abstract: Objective: Owing to inconspicuous memory impairment during early disease stage, patients with dementia with Lewy bodies (DLB) are often diagnosed with mental disorders according to depressive symptoms and visual hallucinations. Severe sensitivity to antipsychotic agents, a DLB characteristic, increases mortality. Herein, we reviewed current challenges and approaches for early DLB detection and appropriate drug use by evaluating pharmacists' ability to recognition of DLB and their level of involvement in medication consultation with dementia patients.Designs: This is a cross-sectional study in Japan.Methods: We provided an anonymous self-administered survey questionnaire to 372 community pharmacists. Descriptive statistics,chi-square test (attributes, recognition, and experiences with medication consultation), and content analysis (free description of drug hypersensitivity) were used for data analysis.Results: The recognition rates for questions on DLB symptoms were as follows: visual hallucinations, 76%; delusion, 63%; other symptoms, including those categorized as core clinical features, such as fluctuating cognition, and REM sleep behavior disorder,＜40%. The rate of other symptoms was similar to that of false recognition of Alzheimer's disease symptoms. The recognition rate of certain DLB symptoms varied depending on pharmacists' experience in medication consultation with dementia patients and drug-induced evaluation during delirium/cognitive decline over the previous month. Approximately 65% of the participants did not respond to open questions on symptoms suggestive of drug hypersensitivity, whereas 55% of those who responded referred to allergic symptoms such as rashes.Conclusion: Owing to their lack of recognition of DLB symptoms, the current contribution of pharmacists to early DLB detection and proper drug use is limited. Thus, it is important to provide patients' observation points and method of questioning during interviews so that pharmacists can easily recognize DLB symptoms. It is critical to clarify that DLB drug hypersensitivity is attributed to mechanisms different from that of drug allergy.