Tifratene_2012_Pharmacoepidemiol.Drug.Saf_21_1005

PURPOSE To examine the way in which specific drug treatments for Alzheimer's disease are used and whether their use complies with clinical practice guidelines issued by the French National Authority for Health in patients with Alzheimer's disease METHODS We analysed a cross-section of the French National Alzheimer's databank BNA Participants were individuals who consulted centres contributing to the BNA in 2010 and diagnosed with Alzheimer's disease and with at least one Mini Mental State Examination MMSE score recorded during the course of the year RESULTS Of 191 919 consultations recorded in the database 29.9 involved a diagnosis of Alzheimer's disease and 26 809 patients had completed at least one MMSE In 76.9 of cases treatment was given with an anti-Alzheimer's drug Monotherapy with an acetylcholinesterase inhibitor was prescribed for 48.3 of patients monotherapy with memantine in 14.2 and dual therapy in 14.4 of cases Treatment given did not comply with the guidelines in 20.7 of cases Prescriptions not complying with the guidelines were associated with a lower mean MMSE score 13.6 vs 18.0 p 0.00001 and more cases of treatment with antidepressants 29.2 vs 22.8 p 0.00001 anxiolytics 14.7 vs 12.3 p 0.00001 and antipsychotics 8.7 vs 4.9 p 0.00001 CONCLUSION Four of five prescriptions for treatment with anti-Alzheimer's drugs complied with the specific drug treatment chapter of the 2008 French clinical guidelines Prescriptions not complying with the guidelines for acetylcholinesterase inhibitors and memantine were usually issued in situations involving advanced-stage Alzheimer's disease The BNA can provide precise information on medical practice in Alzheimer's disease and related disorders.