Abstract

BackgroundCommunity-dwelling persons with dementia commonly use dietary supplements (DS), often without receiving help with the administration. Patient safety is a concern, as DS-drug interactions and adverse events are potential complications. Since many persons with dementia buy their DS in pharmacies, we investigated Norwegian pharmacy employees’ attitudes and professional practice behaviors related to DS.MethodsWe conducted a survey in eight Norwegian municipalities of pharmacy employees involved in the sale of DS. The questionnaire covered demographics and investigated attitudes toward DS, professional practice behaviors related to the sale of DS, experiences with customers with dementia, and perceived and attributed responsibilities with regard to patient safety.ResultsOne hundred and five employees responded (response rate: 52%). Most employees regarded general practitioners (GPs) as primarily responsible for safeguarding the use of DS by persons with dementia and rated themselves less responsible. Thirty-seven percent of the employees reported personal use of DS (past or current use). Nine percent considered some of the DS to have symptomatic or prophylactic effects against dementia. Forty-eight percent confirmed that they informed customers about potential adverse events; 42% indicated that they did this sometimes. Sixteen percent checked regularly for DS-drug interactions, and two-thirds checked depending on the customers’ health, the type of drug or the type of DS. One-quarter regularly asked about the co-use of prescription drugs (PD) when selling DS, while only 2% asked about the co-use of DS when dispensing PD. Only 25% reported access to independent scientific information on all or most DS sold in their pharmacy. Eight percent had experienced unsafe use of DS by persons with dementia. Six percent had been taught about counselling persons with dementia. Education level influenced professional practice behavior to some extent.ConclusionPharmacy employees do not see themselves as primarily responsible for the safe use of DS by persons with dementia. Moreover, they have limited experience with the unsafe use of DS by these persons. There is potential for improvement regarding tools and educational interventions for pharmacy employees to provide sufficient help to persons with dementia who use DS.

Highlights

  • Community-dwelling persons with dementia commonly use dietary supplements (DS), often without receiving help with the administration

  • There were no other differences between the pharmacists and pharmacy technicians in attitudes toward DS

  • Our results showed that pharmacy employees perceive themselves and home care service employees as contributors to safeguarding the use of DS by persons with dementia, but pharmacy employees suggest that General practitioner (GP) should be the main responsible care-taker in maintaining patient safety

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Summary

Introduction

Community-dwelling persons with dementia commonly use dietary supplements (DS), often without receiving help with the administration. Patient safety is a concern, as DS-drug interactions and adverse events are potential complications. Clinically relevant interactions between DS and PD have been reported in 11–33% of persons with dementia who use DS [6, 12]. Due to reduced cognitive function, persons with dementia are at risk of misdosing or confusing DS with PD or vice versa, imposing additional risks on this particular patient group. Another concern is that two-thirds of persons with dementia using DS receive no help with their DS, even though most of them receive help with administering their PD [12]

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