4.7 Article

Prescription Patterns of Antidementia and Psychotropic Drugs in People Living With Dementia: Findings From the Clinical Pathway Study of Alzheimer's Disease in China

Journal

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2021.07.017

Keywords

Dementia; prescribing patterns; antidementia drugs; psychotropic drugs; China

Funding

  1. Novartis China Ltd.
  2. Natural Science Foundation of China [81171018]
  3. National Key Technology Research and Development Program of the Ministry of Science and Technology of the People's Republic of China [2017YFC1311100]

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This study examined prescribing rates of dementia medication in China and found that the prescription rate of antidementia drugs was higher, while the rate of coprescription of psychotropic and antidementia drugs was lower than in Western studies. The prescription of dementia medication in China was generally consistent with clinical guidelines and depended on patients' clinical symptoms.
Objectives: Evidence about prescribing patterns of dementia medication in China is lacking. This study aimed to examine prescribing rates of antidementia and psychotropic drugs and factors associated with drug prescription for dementia in China. Design: A multicenter observational study. Setting and Participants: This study employed cross-sectional data from the Clinical Pathway for Alzheimer's Disease in China study that was conducted in 28 memory clinics at tertiary hospitals across 14 provinces between 2012 and 2013. Patients aged >= 45 years with a diagnosis of dementia were included. Methods: Antidementia and psychotropic drugs were classified according to the Anatomical Therapeutic Chemical codes. Odds ratios (ORs) of putative factors associated with prescription patterns were estimated using logistic regressions. Results: A total of 751 respondents were included in this study, 77.8% of whom were prescribed antidementia drugs, and 33.0% were prescribed at least 1 psychotropic drug. The concomitant prescription rate of antidementia and psychotropic drugs was 24.1%. Frontotemporal dementia [OR 9.92 (99.17% CI 3.08-42.70)], severe dementia [4.25 (1.88-9.79)], and apathy [1.94 (1.18-3.20)] were significantly associated with an elevated likelihood of memantine prescription. Psychotic symptoms [1.84 (1.02-3.35)], agitation [1.91 (1.08-3.40)], and depressive symptoms [2.10 (1.12-3.94)] were significantly associated with the coprescription of antidementia and psychotropic agents. Conclusions and Implications: The prescribing rate of antidementia drugs in the study sample was higher, whereas the rate of coprescription of psychotropic and antidementia drugs was lower than reported in Western studies. Dementia prescription practice was generally consistent with clinical guidelines in memory clinics in China, whereas the prescription of antidementia and psychotropic medication mainly depended on patients' clinical symptoms. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

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