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Use of antidementia drugs in German patients with Alzheimer’s disease

Hessmann, Philippa,b; Dodel, Richardc,d; Baum, Erikae; Müller, Matthias, J.f,g; Paschke, Gretah; Kis, Bernharda; Zeidler, Janb; Klora, Mikeb; Reese, Jens-Peteri; Balzer-Geldsetzer, Monikac

International Clinical Psychopharmacology: March 2018 - Volume 33 - Issue 2 - p 103–110
doi: 10.1097/YIC.0000000000000205
ORIGINAL ARTICLES
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The objective of this study was to evaluate the use of antidementia drugs (ADDs) in patients with Alzheimer’s disease (AD) regarding German guideline recommendations and to assess correlations between the use of ADDs and the patients’ characteristics. A total of 395 community-dwelling and institutionalized patients with AD across all severity stages of dementia were recruited in this cross-sectional study. Associations between the prescription of ADDs and patients’ sociodemographic and clinical parameters (neuropsychiatric symptoms, cognitive capacity, daily activities, and health-related quality of life) were analyzed in multiple logistic regression analyses. ADDs were prescribed in 46.6% of all participants and less often in institutionalized patients (38.2 vs. 50.4%, P=0.025). Patients with mild-to-moderate dementia had a higher chance of receiving ADDs [odds ratio (OR)=3.752, 95% confidence interval (CI): 1.166–12.080 and OR=3.526, 95% CI: 1.431–8.688] as well as those treated by neurologists/psychiatrists (OR=2.467, 95% CI: 1.288–4.726). Overall, 39% of the patients with mild cognitive deficits (Mini-Mental Status Examination 27–30) received ADDs and 21% of the mildly demented patients (Mini-Mental Status Examination 20–26) received memantine. The treatment with ADDs was in part not in line with German guideline recommendations. Particularly, the lower use of ADDs in patients not attending neuropsychiatric specialists should be further evaluated.

aDepartment of Psychiatry and Psychotherapy, University Medical Center Goettingen

bCenter for Health Economics Research Hannover (CHERH), Leibniz University Hannover

cDepartment of Neurology, Philipps-University Marburg

dChair of Geriatrics, University Hospital Essen, Geriatric Centre Haus Berge, Contilia GmbH

eDepartment of General Practice, Philipps-University Marburg

fOberberg Clinics Berlin

gFaculty of Medicine Justus-Liebig-University Giessen

hPractice for General Medicine, Wiesbaden

iCoordinating Center for Clinical Trials, Philipps-University Marburg, Germany

Correspondence to Philipp Hessmann, MD, MPH, Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Von-Siebold-Strasse 5, 37075 Goettingen, Germany Tel: +49 551 39 66610; fax: +49 551 39 9337; e-mail: philipp.hessmann@med.uni-goettingen.de

Received August 7, 2017

Accepted September 27, 2017

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