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Published online: 2024-01-22

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Audit of Alzheimer’s disease management from a tertiary hospital in Brunei Darussalam

Shi Ying Tan1, Shyh Poh Teo12

Abstract

Background: Alzheimer’s disease (AD) is the most common cause of dementia. Management of AD is dynamic and multidisciplinary, involving pharmacological and non-pharmacological interventions to manage patient’s symptoms, prevent clinical decline and improve quality of life. This study aims to evaluate the standard of patient care provided for the management of AD.

Patients and methods: This was a retrospective clinical audit of patients in Brunei Darussalam, with the International Classification of Disease and related health problems, tenth revision (ICD-10) diagnosis of AD between 2019 and 2020.

Results: There was a total of 168 patients (68 males, 100 females). Their mean age was 79.5 years. Only half of the patients (n = 84) were advised on measures to take to slow down the progression of the disease, and less than half (49.1%) of eligible patients were offered cognitive stimulation therapy. 51.8% (n = 87) were referred to occupational therapists for assessment of activities of daily living. 113 patients (67.3%) were started on cognitive enhancers; of these, 92 were continued on these medications. Donepezil was the most common drug prescribed (n = 78). Only 44.2% (n = 50) of the 113 patients were maximized on their cognitive enhancer dose. 84.1% had documented follow-up evaluations on the effect of cognitive enhancers. 88 (52.4%) patients had behavioural and psychological symptoms of dementia (BPSD), of whom 64 (72.7%) received treatment, with quetiapine (n = 33, 51.6%) being the most prescribed drug.

Conclusions: There are still gaps between guidelines and practice; more effort is needed to improve achieving the standards of care for the management of AD in Brunei Darussalam.

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