Treatment pathway analysis of newly diagnosed dementia patients in four electronic health record databases in Europe

Soc Psychiatry Psychiatr Epidemiol. 2021 Mar;56(3):409-416. doi: 10.1007/s00127-020-01872-2. Epub 2020 Jun 3.

Abstract

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.

Keywords: Alzheimer’s disease; Dementia; Epidemiology; Real-world data.

MeSH terms

  • Alzheimer Disease* / diagnosis
  • Alzheimer Disease* / drug therapy
  • Electronic Health Records*
  • Europe
  • Galantamine
  • Humans
  • Indans
  • Italy
  • Netherlands
  • Phenylcarbamates
  • Piperidines
  • Retrospective Studies

Substances

  • Indans
  • Phenylcarbamates
  • Piperidines
  • Galantamine