Community Pharmacists’ Knowledge Regarding Donepezil Averse Effects and Self-Care Recommendations for Insomnia for Persons with AD

Abstract

Alzheimer’s disease (AD) impacts millions of individuals worldwide. Since no cure is currently available, acetylcholinesterase inhibitors are symptomatic therapy. This study assessed community pharmacists’ knowledge regarding donepezil adverse effects (AEs) and self-care recommendations for insomnia management for persons with AD treated with rivastigmine. This is a cross-sectional, standardized telephone survey of community pharmacists (n = 862) in three study areas: West Virginia, North Dakota/South Dakota, and Southern Oregon/Northern California. Pharmacists’ degree, sex, and pharmacists’ AD-related knowledge were assessed. In-stock availability of donepezil and rivastigmine formulations was assessed. Analyses were performed using Stata 10.1. Only 31.4% pharmacists were able to name ≥2 donepezil AEs. Only four donepezil AEs were named by at least 13% of pharmacists: nausea (36.1%), dizziness (25.1%), diarrhea (15.0%), and vomiting (13.9%). All other AEs were named by fewer than 7% of respondents. Only 62.9% of pharmacists (n = 542) provided appropriate recommendations: melatonin (40.3%), referral to physician (22.0%), or sleep hygiene (0.6%). Over 12% of pharmacists (n = 107) provided inappropriate recommendations (anticholinergic agent or valerian root) and 21.5% of pharmacists were unable to provide any recommendation. We identified significant gaps in community pharmacists’ knowledge regarding donepezil AEs and non-prescription insomnia recommendation needing significant improvement to ensure high-quality AD-related care.

Maintaining Vitality: Pharmacists’ Continuing Professional Education Decision-Making in the Upper Midwest

“…A statement of general consensus of a large meeting of experts in pharmacy training and development states that CPE hours are insufficient to ensure pharmacists remain current and adapt to scientific advances and changes in population and community needs and marketplace changes [ 15 ]. This, combined with growing evidence that knowledge in Alzheimer’s disease and dementia care and medications is poor despite rapidly growing aging populations [ 17 , 18 ], as well as with the findings of the current study, that neither community/population need nor business growth/development are among the most important selection criteria for CPE for pharmacists, does not bode well for maintaining professional or organizational vitality in a rapidly changing health care marketplace or for patient-centered care.…”

“…Recent findings by Marvanova and Henkel (2017) on community pharmacists identified knowledge deficits in community pharmacists regarding Alzheimer’s disease-related knowledge, specifically inability to name adverse effects of in-stock cognitive enhancers, and inappropriate non-prescription recommendations for insomnia leading to potentially harmful drug and disease interactions [ 17 , 18 ]. Despite required CPE hours for licensure and efforts of the APhA and ACPE to foster lifelong learning behaviors of pharmacists, it appears CPEs are not currently effective in ensuring that pharmacists, in general, are maintaining up-to-date knowledge, at least with regard to Alzheimer’s disease [ 17 , 18 ]. We do not currently know if this is due to knowledge/skills atrophy, societal changes/medical advances, or both, but such deficits are detrimental to professional and organizational vitality and can negatively impact pharmacy care.…”

Pharmacists’ Knowledge and Practice of Issues Related to Using Psychotropic Medication in Elderly People in Ethiopia: A Prospective Cross-Sectional Study

“…This might be due to the fact that our country has a low-quality controlling system in pharmacy personnel, and less concern is given by the government to improve knowledge of pharmacy personnel. However, there is a higher value with a study done by American community pharmacists regarding donepezil adverse effects [39]. Despite gaps in knowledge, as experts on medications, pharmacists need to be knowledgeable about side effects and drug-drug interactions, including those of psychotropic medications.…”