Nonmedical influences on the use of cholinesterase inhibitors in dementia care

Carol E. Franz, Judith C. Barker, Richard L Kravitz, Yvette Flores, Sheila Krishnan, W Ladson Hinton

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


We examined primary care physicians' (PCPs) attitudes toward cholinesterase inhibitors (ChEI) to better understand nonmedical factors influencing prescribing decisions in dementia care. In a cross-sectional, qualitative study, 40 PCPs were interviewed concerning their general approach to managing patients with dementia, and their care for a particular dementia case. Three readers independently identified and categorized themes associated with prescribing ChEI. Physicians' attitudes toward ChEI were also coded. Physicians were predominantly ambivalent (51%) or negative (31%) about prescribing ChEI for their patients with dementia. Nonmedical factors affecting prescribing included lack of knowledge, dependence on specialists, influence of family wishes and involvement, and physicians' values. PCPs reported that lack of knowledge and experience made prescribing decisions for ChEI challenging. Physicians reported feeling pressured by families to prescribe ChEI. Under these ambiguous conditions, some physicians prescribed medications simply to be able to offer "something" to patients.

Original languageEnglish (US)
Pages (from-to)241-248
Number of pages8
JournalAlzheimer Disease and Associated Disorders
Issue number3
StatePublished - Jul 2007


  • Cholinesterase inhibitors
  • Cognitive enhancers
  • Dementia treatment
  • Primary care

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Neuroscience(all)


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