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Research article summary:
Goal setting and attainment in Alzheimers disease patients treated with donepezil.
Abstract Extract:
OBJECTIVES: To understand the treatment goals of Alzheimers disease (AD) patients, carers, and physicians; to estimate whether clinically important goals are met during treatment with donepezil; and to compare a measure of goal attainment with standard ... (Full abstract text below) Published 2002Nov
in Journal: J Neurol Neurosurg Psychiatry
(Language : eng)
Full Pubmed Extract
This information was retrieved, real-time, on your behalf from the public area of the Pubmed website:
1. J Neurol Neurosurg Psychiatry.
2002 Nov;73(5):500-7
Goal setting and attainment in Alzheimer's disease patients treated with donepezil.
Rockwood K, Graham JE, Fay S,
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Kenneth.Rockwood@Dal.ca
OBJECTIVES: To understand the treatment goals of Alzheimer's disease (AD) patients, carers, and physicians; to estimate whether clinically important goals are met during treatment with donepezil; and to compare a measure of goal attainment with standard measures used to evaluate AD treatment. METHODS: In a 12 month phase IV trial, 108 patients with mild to moderate AD, their primary carers, and treating physicians set goals assigned to five domains, using Goal Attainment Scaling (GAS) as the primary outcome. Goal attainment was assessed quarterly. GAS scores were correlated with standard outcomes, including the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog), and the Clinician's Interview-Based Impression of Change-Plus (CIBIC-plus). RESULTS: Physicians set fewer goals (342, mean (SD) per patient=3 (1)) than patients/carers (855, mean=9 (3)), particularly in leisure (20% by physicians compared with 76% by patients/carers), and social interaction (24% versus 49%). Physicians observed statistically significant improvement in global goal attainment for six months, and patients/carers for nine months. Patients/carers described consistent goal attainment, whereas physicians observed variable effects, such as decline in cognition but improved social interaction and behaviour. Physician global GAS scores correlated highly with the CIBIC-plus at weeks 12 (r= -0.82) and 52 (r=-0.80), but not with the ADAS-cog (r=0.12 and r=-0.45, respectively). Patient/carer global GAS scores correlated moderately with the physician's CIBIC-plus (week 12 r=-0.51; week 52 r=-0.56), and nominally with the ADAS-cog. CONCLUSIONS: Patients/carers and physicians differ in their expectations and impressions of treatment effects. Clinically important changes correlated only modestly with psychometric tests. Attainment of treatment goals does not accord with a simplistic model in which successful AD treatment means that all declines uniformly improve.
PMID : 12397141 [PubMed - Indexed for MEDLINE]
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Full Author Information
| First Name | LastName | Initials |
| K | Rockwood | K |
| J E | Graham | JE |
| S | Fay | S |
| | |
Affiliation: Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Kenneth.Rockwood@Dal.ca
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MESH categories and related page links
This article was linked to the MESH categories shown on the left below. The links on the right are related Memletics pages.
Category links from this article:- Aged
- Alzheimer Disease - drug therapy
- Cholinesterase Inhibitors - adverse effects, therapeutic use
- Cognition Disorders - diagnosis
- Female
- Goals
- Humans
- Indans - adverse effects, therapeutic use
- Interpersonal Relations
- Male
- Neuropsychological Tests
- Piperidines - adverse effects, therapeutic use
- Professional-Patient Relations
- Prospective Studies
- Psychometrics
- Severity of Illness Index
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