TY  - JOUR
A1  - Bohlken, Jens
A1  - Schulz, Mandy
A1  - Rapp, Michael Armin
A1  - Baetzing-Feigenbaum, Joerg
T1  - Pharmacotherapy of dementia in Germany: Results from a nationwide claims database
T2  - European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
N2  - In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050. Dementia poses a major challenge to the healthcare system and neuropharmacological service provision. The aim of this study was to determine prescription rates for anti-dementia drugs as well as for neuroleptics, sedative-hypnotics and antidepressants in dementia using the complete nationwide outpatient claims data pertaining to the services of statutory health insurance. We controlled for gender, age, dementia diagnosis, physician specialty (general practitioner GP versus neuropsychiatry specialist physician NPSP), and rural and urban living area. In about one million prevalent dementia patients (N=1,014,710) in 2011, the prescription prevalence rate of anti-dementia drugs was 24.6%; it varied with gender, age, and diagnosis (highest in Alzheimer's disease; 42%), and was higher in patients treated by NPSPs (48% vs. 25% in GPs). At the same time, we found an alarmingly high rate of treatment with neuroleptics in dementia patients (35%), with an only slightly decreased risk in patients treated exclusively by NPSPs (OR=0.86). We found marginal differences between rural and urban areas. Our results show that the majority of anti-dementia drug prescriptions appear guideline-oriented, yet prescription rates are overall comparatively low. On the other hand, neuroleptic drugs, which are associated with excess morbidity and mortality in dementia, were prescribed very frequently, suggesting excess use given current guidelines. We therefore suggest that guideline implementation measures and increasing quality control procedures are needed with respect to the pharmacotherapy of this vulnerable population. (C) 2015 Elsevier B.V. and ECNR All rights reserved.
KW  - Psychotropics
KW  - Drug prescription
KW  - Germany
Y1  - 2015
UR  - https://publishup.uni-potsdam.de/frontdoor/index/index/docId/38392
SN  - 0924-977X
SN  - 1873-7862
VL  - 25
IS  - 12
SP  - 2333
EP  - 2338
PB  - Elsevier
CY  - Amsterdam
ER  -