Episode 85: Alzheimer's - unforgettable podcasts - part II - the scales and the studies
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In episode 85, James and Mike delve into the studies, the scales and some of the treatments for Alzheimer's. We once again have geriatrician Laurie Mallery help us out.
Comments
This past week I saw a
This past week I saw a patient for whom a specialist had prescribed Aricept 5 mg daily.
He came to me asking if he had to take it...because when he went to his local Chemist he found the cost of a 30 day supply was... $257.99. Now, I realize those are U.S. dollars and likely that's only $100 Canadian but that's still a lot of money! I advised he and his wife:
"It is certainly reasonable to try this (avoid removing hope) BUT I want to talk with you every month before you renew it." Then addressed the wife: "If it were me, and my wife could not notice an obvious difference in 3 months, then I would stop it". (Frankly, I'm hoping my wife doesn't EVER spend our money on this...even for three months...but they wanted to give it a try. Perhaps that's a reasonable, patient-centered approach? And, yes, James...I know, my wife would NEVER spend $257.99 a month on me! Cheers, Mark
Very interesting couple of
Very interesting couple of podcasts and it is good to see that you are struggling with this issue just as much as the rest of us.
My only point is the difficulty to assess if the treatment is working. I my experience most relatives overestimate the impact the medication has and are then very reluctant to stop it even when it is patently clear to everybody around that it does nothing. This is understandable when you consider that they have been told that there is nothing else out there, so they clutch at every straw they can get hold of.
Therefore I often feel that starting the medication creates more problems that it is worth.To quote one of Mike's favourite sayings you get very little bang for an awful lot of bucks.
So you have to question the use this medication particularly in a publicly funded health-system.
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