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‘I’ve been in charge of this body for over 70 years but every time I go into hospital I’m expected to leave my responsibility at the door.’ Florence, 79 years. What undesirable events may be experienced…. Headache Stomach upsets, feeling sick, vomiting… Skin rash or itch…
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‘I’ve been in charge of this body for over 70 years but every time I go into hospital I’m expected to leave my responsibility at the door.’ Florence, 79 years
What undesirable events may be experienced…. • Headache • Stomach upsets, feeling sick, vomiting… • Skin rash or itch… • Hair loss or discolouration… • Discolouration of the mucus membranes.. • Blurring or complete loss of vision… • Dizziness or light-headedness… • Hearing loss and tinnitus…
Outcome measures for anti-cholinesterase drugs from a professional perspective • An improvement of at least 3 points on the ADCog. • Delay in admission to institutional care • Maintenance of ADLs
What people affected by dementia want from a medicine. • Improvements in mood • Increased confidence • Reduction in fear and distress J Cream, H Cayton CPD Bulletin 2001: 2(3)
Do carer’s interests matter? • Reduction in caring for challenging behaviours • Reduction in anxiety • Improved sleep
Realistic expectations ‘People with Alzheimer’s and their carers are realistic…they recognise that a cure is not available and are modest in what they ask for…People attribute great value to small every day improvements’ J Cream, H Cayton CPD Bulletin 2001 2(3) 80-82
Benefits of user defined outcomes • They meet people’s needs more precisely • They are likely to be realistic • They relate to the context of people’s lives • Concordance will be greater Thus they will be clinically and cost effective.