Prescription profile of Alzheimer’s disease medications in the public health system in Southern Brazil

Abstract

AbstractBackgroundAlzheimer’s disease (AD) accounts for 60‐70% of cases of dementia, and is characterized by progressive decline in cognition and functionality. Pharmacological treatment is fundamentally symptomatic, and consist mainly of three acetylcholinesterase (IChE) inhibitors (donepezil, galantamine and rivastigmine) and one N‐methyl‐D‐aspartate (NMDA) receptor, memantine. Although these drugs are freely available in the public health system in Brazil, there may be barriers to accessing them. We aim to evaluate the profile of prescription of AD medication in the public health system in the state of Rio Grande do Sul (RS), Southern Brazil.MethodsWe analyzed all AD medications requested in the state of RS during October/2021 in the public health system. Sociodemographic, Mini Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR) scale data were collected. We described the variables as median (interquartile range ‐ IQR) or frequencies. We also performed a spatial autocorrelation analysis of the medication prescribed in the RS municipalities. All analyses were performed in R.ResultsThe total of 2,382 AD patients were using any AD medication. Most were female (65.6%), had elementary education (71.7%) and a median age of 79 (73‐84) years. The patients' MMSE median was 15 [12‐18] and most had a CDR = 2 (55.2%, 1133). The most prescribed medication was donepezil, 42.6% (1014), alone or in combination with memantine (Table 1). The distribution of the variable patient/100,000/municipality was clustered, with Moran’s I of 0.17562 (p<0.001) (Figure 1).ConclusionsMost patients using AD medications in the public health system had moderate dementia. The distribution pattern of these medications in the RS state was uneven. The identification of factors related to these patterns may provide valuable information about the barriers to the access to AD treatment in the state of RS.