The role of the treating practice in persistence among dementia patients inGermany and the UK .

Abstract

There is a lack of studies investigating the role of physicians with regard to persistence among dementia patients. The aim was to analyze the rate of persistence with antidementia medication in Germany and the UK by focusing on the role of the treating physician. Dementia patients who had received at least 1 prescription for antidementia drugs in 240 general practices in Germany and 73 general practices in the UK between January 2013 and December 2016 were included. Persistence was defined as the time between therapy initiation and therapy discontinuation, the latter being defined as a gap of at least 90 days without antidementia therapy. The prevalence of persistent patients per practice was also estimated. High practice persistence was defined as > 60% of patients completing at least 12months of therapy. A total of 3,863 patients in Germany and 3,342 patients in the UK were analyzed. In Germany, 55.2% of patients were continuing therapy after 12months, while the figure in the UK was 80.2%. The proportion of patients with a persistence of at least 12 months per practice ranged from 0 to 80% in Germany and from 0 to 85% in the UK. The prevalence of practices with good persistence was lower in Germany than in the UK (9.6 versus 54.8%). Physicians play an important role with respect to the persistence of the dementia patients they treat. Further studies are needed to better understand the role of physicians of other specialties in patients' adherence.