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 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.
|ジャーナル名||Social psychiatry and psychiatric epidemiology|
|投稿者||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, Solene; Gungabissoon, Usha; Egger, Peter; Stewart, Robert; Celis-Morales, Carlos; Alexander, Myriam; Novak, Gerald; Gordon, Mark Forrest|
|組織名||AstraZeneca, Academy House, 136 Hills Road, Cambridge, CB2 8PA, UK.;email@example.com.;Servier, Paris, France.;GlaxoSmithKline, Stevenage, UK.;Boehringer Ingelheim, Ingelheim Am Rhein, Germany.;Erasmus Medical Centre, Rotterdam, The Netherlands.;Harvard Medical School, Cambridge, USA.;Aarhus University, Aarhus, Denmark.;The Health Improvement Network, London, UK.;Health Search Database, Florence, Italy.;King's College London, London, UK.;South London and Maudsley NHS Foundation, London, UK.;University of Glasgow, Glasgow, UK.;Janssen Pharmaceutical, New York, USA.;Teva Pharmaceuticals, Inc, Frazer, USA.|