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  1. A review and commentary on a sample of 15 UK guidelines for the drug treatment of Alzheimer's disease.

    Article - En anglais

    Background

    There has been widespread development of clinical guidelines for the treatment of Alzheimer's disease since the introduction of donepezil in the UK in 1997.

    These have been developed nationally, regionally, locally and by independent groups.

    An independent review of guidelines available in the public domain was commissioned to provide an overview of the range and variability in the recommendations being made.

    Methods

    Fifteen sets of guidelines obtained from a variety of sources were reviewed in a standardized way to extract the recommendations being made in the following areas :

    • diagnosis ;

    • investigations ;

    • the evidence base of the recommendations ;

    • initiation of drug treatment ;

    • monitoring and dose adjustment ;

    • and decision-making on maintenance or discontinuation of treatment.

    Results, None of the documents fulfilled criteria for high-quality evidence-based guidelines.

    Substantial variability was evident in all areas of recommendation.

    All of the guidelines appeared to be based upon consensus opinion.

    Only one incorporated a statement of potential conflicts of interest affecting the working group who developed the guideline.

    Conclusions

    The lack of consistency found in this sample of guidelines would inevitably lead to inequalities in the health care delivered in different areas. (...)

    Mots-clés Pascal : Démence Alzheimer, Chimiothérapie, Traitement, Recommandation, Inhibiteur enzyme, Cholinesterase, Carboxylic ester hydrolases, Esterases, Hydrolases, Enzyme, Anticholinestérasique, Diagnostic, Royaume Uni, Europe, Personne âgée, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Maladie dégénérative

    Mots-clés Pascal anglais : Alzheimer disease, Chemotherapy, Treatment, Recommendation, Enzyme inhibitor, Cholinesterase, Carboxylic ester hydrolases, Esterases, Hydrolases, Enzyme, Anticholinesterase agent, Diagnosis, United Kingdom, Europe, Elderly, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Degenerative disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0277576

    Code Inist : 002B02B09B. Création : 16/11/1999.