Analysis of medication situation of Alzheimer's disease on hospitals of six cities in China

Abstract

Objective To understand the medication situation of Alzheimer's disease(AD) of six cities in China Methods The data were from 50 hospitals of six cities (including Beijing, Tianjin, Shanghai, Guangzhou, Chengdu and Hangzhou) in China which involved in the Hospital Prescription Analysis Cooperative Project. Prescriptions from Department of Outpatient and Emergency, doctor's orders of inpatients in 40 days in each hospital in each year from 2012 to 2014 were selected randomly. The information of medication use about AD was extracted and analyzed using software of Visual FoxPro 8.0 and SPSS 22.0. Results There were 59 891 AD patients in six cities. The patients' prevalence peak was in 75 to 89 years, accounted for 66.9% of the total cases of AD patients (40 096 patients). Application of cholinesterase inhibitors (ChEI) and N-methyl-D-aspartate (NMDA) receptor antagonist accounted for 46.5% of the total cases of AD patients (27 827/59 891), behavioral and psychological symptoms of dementia (BPSD) accounted for 26.4% (15 811/59 891), neural nutrition agent accounted for 15.1% (9 043/59 891), prevention of AD accounted for 11.7% (7 007/59 891). There were no significant differences in constituent ratios of ChEI use alone, NMDA receptor antagonist use alone, or ChEI combined with NMDA receptor antagonist treatment in AD patients in the 3 years (P>0.05). The compound annual growth rate was 69.6% of ChEI combined with NMDA receptor antagonist treatment. The top 3 drugs in AD patients were donepezil (14 254 patients), memantine (12 278 patients), and olanzapine (4 612 patients). Total amount of AD patients' prescriptions was 20.124 million yuan, of the top 15 drugs according to the cost for AD treatment, the cost of first-line therapy was 9.129 million yuan (45.4%), the cost of BPSD was 1.538 million yuan(7.6%), the cost of neural nutrition agent was 1.278 million yuan (6.4%), and the cost of prevention of AD was 0.433 million yuan (2.2%). Conclusions Chinese doctors in six cities could follow European and Chinese AD treatment guidelines and implement multi-target drug combination regimen for AD patients. The use of drugs in this AD patients was basically reasonable. But there were some problems in which doctors prescribed ineffective drugs, leading to heavy economic burden in AD patients. Key words: Alzheimer disease; Therapy; China