Treatment pathway analysis of newly diagnosed dementia patients in four electronic health record databases in Europe

Purpose Real-world studies to describe the use of first, second and third line therapies for the management and symptomatic treatment of dementia are lacking. This retrospective cohort study describes the first-, second- and third-line therapies used for the management and symptomatic treatment of d...

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Published in:Social Psychiatry and Psychiatric Epidemiology 2021-03, Vol.56 (3), p.409-416
Main Authors: James, Glen, Collin, Estelle, Lawrance, Marcus, Mueller, Achim, Podhorna, Jana, Zaremba-Pechmann, Liliana, Rijnbeek, Peter, van der Lei, Johan, Avillach, Paul, Pedersen, Lars, Ansell, David, Pasqua, Alessandro, Mosseveld, Mees, Grosdidier, Solène, Gungabissoon, Usha, Egger, Peter, Stewart, Robert, Celis-Morales, Carlos, Alexander, Myriam, Novak, Gerald, Gordon, Mark Forrest
Format: Article
Language:English
Subjects:
Alzheimer Disease - diagnosis
Alzheimer Disease - drug therapy
Alzheimer's disease
Aspartate
Dementia
Diagnosis
Electronic Health Records
Electronic records
Enzyme inhibitors
Epidemiology
Europe
Galantamine
Health services
Humans
Indans
Italy
Medical records
Medicine
Medicine & Public Health
Methyl aspartate
Netherlands
Original Paper
Phenylcarbamates
Piperidines
Psychiatry
Retrospective Studies
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Summary:Purpose Real-world studies to describe the use of first, second and third line therapies for the management and symptomatic treatment of dementia are lacking. This retrospective cohort study describes the first-, second- and third-line therapies used for the management and symptomatic treatment of dementia, and in particular Alzheimer’s Disease. Methods Medical records of patients with newly diagnosed dementia between 1997 and 2017 were collected using four databases from the UK, Denmark, Italy and the Netherlands. Results We identified 191,933 newly diagnosed dementia patients in the four databases between 1997 and 2017 with 39,836 (IPCI (NL): 3281, HSD (IT): 1601, AUH (DK): 4474, THIN (UK): 30,480) fulfilling the inclusion criteria, and of these, 21,131 had received a specific diagnosis of Alzheimer’s disease. The most common first line therapy initiated within a year (± 365 days) of diagnosis were Acetylcholinesterase inhibitors, namely rivastigmine in IPCI, donepezil in HSD and the THIN and the N -methyl- d -aspartate blocker memantine in AUH. Conclusion We provide a real-world insight into the heterogeneous management and treatment pathways of newly diagnosed dementia patients and a subset of Alzheimer’s Disease patients from across Europe.
ISSN:0933-7954
1433-9285
DOI:10.1007/s00127-020-01872-2