Slattum_2004_Consult.Pharm_19_352

OBJECTIVE: To review the literature pertaining to caregiver burden in Alzheimer's disease (AD) and the role of medications and the pharmacist in reducing caregiver burden. DATA SOURCES: A MEDLINE search was conducted to identify relevant studies, review articles, case reports, and letters in the English language published from 1985 to September 2003. Additional references were obtained from bibliographies of these articles. STUDY SELECTION: All studies evaluating caregiver burden and AD, as well as the role of medications in reducing caregiver burden that were accessible to the authors. DATA SYNTHESIS: Caring for the caregiver is a significant part of managing a patient with AD. Many predictors of caregiver burden in AD have been identified. A number of measurement tools have been developed to assess caregiver burden in the research setting. A wide variety of interventions to reduce caregiver burden have been studied. These interventions range from education and support services to drug therapies. Most often these strategies have been studied individually; however, combining drug treatments with nonpharmacologic interventions may be the best approach to improve the quality of life for the caregiver of a patient with dementia and the care recipient. Most of the studies to date of drug therapy and caregiver burden have evaluated cholinesterase inhibitors. Other drug therapies that have been studied include memantine, antipsychotics, antidepressants, and selegiline. PRIMARY CONCLUSIONS AND CLINICAL APPLICATIONS: The pharmacist can play an important part in reducing the caregiver burden associated with AD. It is important to identify caregivers at risk for experiencing significant caregiver burden since the consequences of excess burden to the caregiver-and the care recipient-can be devastating. Among the many tasks of providing such care, caregivers are responsible for administering and managing medications. The difficulties associated with the care recipient's medications can be reduced through effective communication, education, and services available from a pharmacist. Pharmacists are probably the most accessible health care professional for the caregiver. Being able to provide accurate information about AD and its management is an important way to ease the burden of care. Finally, pharmacists can play a significant part in supporting the community in caring for the families of patients with Alzheimer's disease by volunteering with the local chapter of the Alzheimer's Association.