Are medical doctors in Latin America prepared to deal with the dementia epidemic?

Richly, Pablo; López, Pablo; Prats, Montserrat; Mastadueno, Ricardo; Bustín, Julián; Gonzalez, Macarena; Flichtentrei, Daniel; Manes, Facundo; O'Neill, Santiago

doi:10.1017/s1041610218001825

Cited by 4 publications

(11 citation statements)

References 3 publications

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“…This study results with a large proportion of NRD prescriptions, which are consistent with other studies that showed that Latin‐American medical doctors, especially general practitioners, reported insufficient knowledge for dementia diagnosis and management …”

Section: Discussionsupporting

confidence: 92%

“…This study results with a large proportion of NRD prescriptions, which are consistent with other studies that showed that Latin-American medical doctors, especially general practitioners, reported insufficient knowledge for dementia diagnosis and management. 27 Very few studies have examined, in an epidemiological manner, the topic of recommended and not recommended use of drugs in CI. A recent paper analyzed 1 733 916 users of the recommended antidementia drugs (donepezil, galantamine, memantine, and rivastigmine) in Japan between April 2015 and March 2016.…”

Section: Discussionmentioning

confidence: 99%

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What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

Bustín

Rojas

O'Neill

et al. 2019

Int J Geriat Psychiatry

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Objectives: The only recommended pharmacological treatments for specific dementias are donepezil, galantamine, rivastigmine, and memantine (recommended drugs, RD). However, other drugs without recommendations (not recommended drugs, NRD) are often used to treat patients with cognitive impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost, and implications of NRD used for the treatment of CI in the INSSJyP. Materials: This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared with the same database in 2009. The number of "prescriptions" always refers to dispensed packages. Results: A total of 3 255 438 packages of drugs usually indicated for CI were prescribed during 2015: 1 912 476 packages of RD (59%) and 1 342 962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 million USD. NRD cost represented approximately 20 million USD. Conclusion: Inappropriate drug use increases health costs in developing countries.We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modify behavioral insights about appropriate prescription for specific dementias.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

Bustín

Rojas

O'Neill

et al. 2019

Int J Geriat Psychiatry

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show abstract

“…One main limitation of this work is the use of self‐report surveys, which are influenced by social desirability. Nevertheless, this limitation is general for surveys on dementia 6,8,10,44 . Moreover, we have focused on professionals working in the field, maximizing the expertise that informs these opinions.…”

Section: Discussionmentioning

confidence: 99%

“…Their opinions and beliefs are powerful forces that drive future impact 6 . Although limited in the region, 7–9 accessibility and transmission of public policies are critical components of expert knowledge 10,11 . Knowledge transmission can also address social barriers such as stigma, 12–17 and can be instrumentalized to enhance clinical care and treatment via the use of diagnostic manuals and data‐sharing platforms 9,18–24 .…”

Section: Introductionmentioning

confidence: 99%

The power of knowledge about dementia in Latin America across health professionals working on aging

Ibáñez

Flichtentrei²,

Hesse

et al. 2020

Alzheimer's & Dementia: Diagnosis, Assessment &

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Introduction Expert knowledge is critical to fight dementia in inequitable regions like Latin American and Caribbean countries (LACs). However, the opinions of aging experts on public policies’ accessibility and transmission, stigma, diagnostic manuals, data‐sharing platforms, and use of behavioral insights (BIs) are not well known. Methods We investigated opinions among health professionals working on aging in LACs (N = 3365) with regression models including expertise‐related information (public policies, BI), individual differences (work, age, academic degree), and location. Results Experts specified low public policy knowledge ( X 2 = 41.27, P < .001), high levels of stigma ( X 2 = 2636.37, P < .001), almost absent BI knowledge ( X 2 = 56.58, P < .001), and needs for regional diagnostic manuals ( X 2 = 2893.63, df = 3, P < .001) and data‐sharing platforms (X 2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI‐based treatment for a proposed prevention program improved perception across experts. Discussion Our findings help to prioritize future potential actions of governmental agencies and non‐governmental organizations (NGOs) to improve LACs’ dementia knowledge.

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“…It is estimated that 60% of all people living with dementia today reside in low and middle-income countries like those in Latin America, and this proportion is expected to increase (World Alzheimer Report 2015). Unfortunately, physicians seem to have a poor knowledge about this condition (Richly et al, 2018), and this may impact their approach to subjects with dementia (Jacinto et al, 2016).…”

mentioning

confidence: 99%

How are medics approaching people with dementia in Latin America?

Richly

O'Neill²,

Flichtentrei³

et al. 2019

Int. Psychogeriatr.

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Are medical doctors in Latin America prepared to deal with the dementia epidemic?

Cited by 4 publications

References 3 publications

What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

The power of knowledge about dementia in Latin America across health professionals working on aging

How are medics approaching people with dementia in Latin America?

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