Use of drug treatments for Alzheimer's disease in France: a study on a national level based on the National Alzheimer's Data Bank (Banque Nationale Alzheimer)

Tifratene, Karim; Duff, F. Le; Pradier, Christian; Quetel, Julien; Lafay, Pierre; Schück, Stéphane; Benzenine, Éric; Quantin, Catherine; Robert, Philippe

doi:10.1002/pds.3303

Cited by 17 publications

(12 citation statements)

References 28 publications

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“…Lopez et al [ 27 ] found that users of combination therapy comprised 14.9 % of their sample. Similar percentages were found by Tifratene et al [ 17 ] who reported 14.4 % of users of combination therapy in their nationwide sample. This finding is different from the results of our analysis, which showed less utilisation of combined antidementia drug treatments.…”

Section: Discussionsupporting

confidence: 89%

“…In our data, we found that 11 % (n = 29) of the cholinesterase inhibitors and memantine was inconsistent with national guideline recommendations with respect to daily dose. Tifratene et al found 20.7 % of antidementia pharmacotherapy to be non-compliant with national guidelines [ 17 ]. Therefore, discrepancies between guideline recommendations and utilisation data are common, based on the work of Tifratene et al However, our definition of target dose would not detect non-compliance.…”

Section: Discussionmentioning

confidence: 99%

“…In a register based study, Taipale et al [ 16 ] observed that 84 % of the 6,858 community-dwelling PWD were being treated with at least one antidementia drug. A study in France by Tifratene et al [ 17 ] showed that 76.9 % of the 26,809 individuals who were registered in the French National Alzheimer’s Bank and had received a diagnosis were treated with antidementia drugs.…”

Section: Introductionmentioning

confidence: 99%

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Antidementia drug treatment in dementia networks in Germany: use rates and factors associated with treatment use

Wübbeler

Wucherer

Hertel

et al. 2015

BMC Health Serv Res

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BackgroundDementia networks in Germany constitute a specialised setting for integrated dementia care and have shown benefits on relevant outcomes, including those of drug treatment. National guidelines recommend treatment with acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) or the N-Methyl-D-Aspartate antagonist (memantine) to reduce cognitive symptoms. However, prescription rates are lower than 30 % in general practises. This study aims to describe antidementia drug treatment and the factors that are associated with the treatment in different dementia networks across Germany.MethodsWe have analysed the socio-demographic, clinical and utilisation data from 560 patients with dementia (PWD), as well as data from their caregivers, in 13 selected dementia networks in Germany. The patients and caregivers were interviewed in their homes or in the network facilities. Multiple logistic regression models were fitted to evaluate the socio-demographic and clinical factors associated with the utilisation of antidementia drug treatment in the various networks.ResultsIn all of the networks in the study, 52 % of the participants received an antidementia drug treatment. Factors associated with the utilisation of the antidementia drug treatment were: formal diagnosis (OR = 16.81, p < 0.001), association with a physician in the network (OR = 3.69, p < 0.001), higher number of comorbidities (OR = 0.88, p = 0.039), living alone (OR = 0.51, p = 0.032) and higher age (OR = 2.97, p = 0.002).ConclusionMedical treatment of PWD with antidementia drugs in dementia networks in Germany is more frequent than in primary and nursing home care settings. Our findings also suggest that participants with a formal diagnosis and a physician in the network have increased rates of receiving antidementia drug treatments. These findings suggest that dementia networks focusing on medical treatment should support diagnostic procedures and incorporate physician specialists.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antidementia drug treatment in dementia networks in Germany: use rates and factors associated with treatment use

Wübbeler

Wucherer

Hertel

et al. 2015

BMC Health Serv Res

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“…Although concomitant use has infrequently been reported, a similar prevalence has been described by Brewer et al (2013) among users of antidementia drugs in Ireland. In a study by Tifratene et al (2012) conducted in France, the prevalence of concomitant use was about 19% of AChEI users, although their national treatment guidelines did not recommend concomitant use. The Finnish Current Care Guideline states that concomitant use may be beneficial in moderate-to-severe AD (Finnish Medical Society Duodecim, Helsinki, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, AChEIs are recommended for treatment of mild-to-moderate AD in Sweden (National Board of Health and Welfare, 2010). Some insurance schemes have restrictions for reimbursement of AChEIs (van den Bussche et al , 2011), whereas the French guideline does not recommend the concomitant use of AChEIs and memantine (French National Authority for Health, 2008; Tifratene et al , 2012). Thus, although the Finnish system requires exact diagnoses before reimbursement is granted, the use of antidementia drugs after this is less restricted than in many other countries.…”

Section: Introductionmentioning

confidence: 99%

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Taipale¹,

Tanskanen

Koponen³

et al. 2014

International Clinical Psychopharmacology

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The objective of this study was to investigate the prevalence of acetylcholinesterase inhibitor (AChEI) and memantine use, duration of treatment, concomitant use of these drugs, and factors associated with the discontinuation of AChEI therapy during 2006–2009. We utilized data from a nationwide sample of community-dwelling individuals with a clinically verified Alzheimer’s disease diagnosed during the year 2005 (n=6858) as a part of the MEDALZ-2005 study. During the 4-year follow-up, 84% used AChEI and 47% used memantine. Altogether, 22% of the sample used both drugs concomitantly. The median duration of the first AChEI use period was 860 (interquartile range 295–1458) days and 1103 (interquartile range 489–1487) days for the total duration of AChEI use. Although 20% of the AChEI users discontinued the use during the first year, over half of them restarted later. The risk of discontinuation was higher for rivastigmine [hazard ratio 1.34 (confidence interval 1.22–1.48)] and galantamine users [hazard ratio 1.23 (confidence interval 1.15–1.37)] compared with donepezil users in the adjusted model. In conclusion, median time for AChEI use was over 3 years and every fifth Alzheimer’s disease patient used AChEI and memantine concomitantly during the follow-up. The low rate of discontinuation is consistent with the Finnish Care Guideline but in contrast to the results reported from many other countries.

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Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer’s Disease

2014

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Use of drug treatments for Alzheimer's disease in France: a study on a national level based on the National Alzheimer's Data Bank (Banque Nationale Alzheimer)

Cited by 17 publications

References 28 publications

Antidementia drug treatment in dementia networks in Germany: use rates and factors associated with treatment use

Antidementia drug treatment in dementia networks in Germany: use rates and factors associated with treatment use

Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland

Anti-Dementia Drugs and Co-Medication Among Patients with Alzheimer’s Disease

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