Age, marital status and schooling |
Self-report through interviews and medical records |
Alzheimer’s disease |
Patient diagnosed with Alzheimer's disease according to criteria established by the Clinical Protocol and Therapeutic Guidelines of Alzheimer's disease (PCDTDA)* (Costa et al., 2017Costa AF, Chaves MLF, Picon PD, Krug BC, Gonçalves CBT, Amaral KM, et al. Protocolo Clínico e Diretrizes Terapêuticas - Doença de Alzheimer. Portaria conjunta No 13, 28 novembro 2017:147-167.) and in use of one of the drugs of AD drug therapy: galantamine, rivastigmine, donepezil or memantine. |
Stage of Alzheimer’s disease |
Clinical Dementia Rating (Morris, 1993Morris JC. The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology. 1993;43(11):2412-2412. https://doi.org/10.1212/WNL.43.11.2412-a https://doi.org/10.1212/WNL.43.11.2412-a...
) |
Cognitive screening |
Mini-mental State examination (Folstein et al., 1975Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198. https://doi.org/10.1016/0022-3956(75)90026-6 https://doi.org/10.1016/0022-3956(75)900...
) |
Comorbidity |
Self-report in face-to-face interviews and interventions, medical records and drug therapy in use |
Drug therapy in use (pharmaceutical active ingredient, pharmaceutical form, dose, dosage and route of administration) |
Self-report in face-to-face interviews and interventions, medical records and prescriptions |
Benzodiazepines use (drug, dose and time of use) |
Self-report in face-to-face interviews and interventions, medical records and prescriptions |
Hemodynamic parameter |
Parameters of systolic and diastolic blood pressure by means of blood pressure measurement |
Biochemical parameter |
Postprandial capillary glucose; glycated hemoglobin; fasting total cholesterol; fasting triglycerides and prostate specific antigen established by means of self and laboratory tests |
Biochemical parameters of confounding factors of Alzheimer’s disease (hypothyroidism and depression) |
Dosage of thyroid-stimulating hormone (TSH); free thyroxine (T4) and vitamin B12 |
Drug Related Problem |
Classified in indication (unnecessary drug therapy and need for additional therapy); effectiveness (ineffectiveness and drug therapy in very low dose); safety (adverse drug event; medication error and drug therapy in high dose); and adherence (non-adherence) (Cipolle, R.J., Strand, L.M. and Morley, 2012Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice: The Patient Centered Approach to Medication Management. 3rd Edition, McGraw-Hill, Health Professions Division, New York. Pharmacol Pharm. 2012.) |
Therapeutic experience of patient and caregiver/relatives |
Self-report on face-to-face interviews and interventions by patients answering the questions “How do you see your state of health?”, “What has been your experience with medications for your condition?”, “How do you feel about your medications?”, “What do you expect from your medicines?”, “Do you have concerns about your medications?” (Ramalho-de Oliveira et al., 2012Ramalho-de Oliveira D, Shoemaker SJ, Ekstrand M, Alves MR. Preventing and resolving drug therapy problems by understanding patients’ medication experiences. J Am Pharm Assoc. 2012;52(1):71-80. https://doi.org/10.1331/JAPhA.2012.10239. https://doi.org/10.1331/JAPhA.2012.10239...
) |
Adherence to Alzheimer’s disease drug therapy (adherent or non-adherent) |
Non-adherence according to indirect method due to possession with delay of three or more days (Obreli-Neto et al., 2011Obreli-Neto PR, Guidoni CM, Oliveira Baldoni A, Pilger D, Cruciol-Souza JM, Gaeti-Franco, et al. Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. Int J Clin Pharm. 2011;33(4):642-9. https://doi.org/10.1007/s11096-011-9518-x. https://doi.org/10.1007/s11096-011-9518-...
) and therapeutic experience of patient and caregiver/relatives about the drug therapy in use (Ramalho-de Oliveira et al., 2012Ramalho-de Oliveira D, Shoemaker SJ, Ekstrand M, Alves MR. Preventing and resolving drug therapy problems by understanding patients’ medication experiences. J Am Pharm Assoc. 2012;52(1):71-80. https://doi.org/10.1331/JAPhA.2012.10239. https://doi.org/10.1331/JAPhA.2012.10239...
) |
Effectiveness of Alzheimer’s disease drug therapy |
Scores of Mini-mental State Examination and Clinical Dementia Rating according to the guidelines of the PCDTDA (Costa et al., 2017Costa AF, Chaves MLF, Picon PD, Krug BC, Gonçalves CBT, Amaral KM, et al. Protocolo Clínico e Diretrizes Terapêuticas - Doença de Alzheimer. Portaria conjunta No 13, 28 novembro 2017:147-167.) |
Pharmaceutical intervention |
The pharmaceutical interventions consisted of adjustment of medication schedules, adjustment request for or suggestions of other alternatives/pharmaceutical forms for the prescriber; prescription of over the counter medications; guidance about administration and correct use of drug therapy; providing medication in dose-dispensing units by intake schedule and referral to other health professionals. Interventions of educational nature consisted of information on comorbidities, non-pharmacological strategies and self-care. |