Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-28T03:45:41.562Z Has data issue: false hasContentIssue false
  • English
  • Français

Prescribing of drugs for Alzheimer's disease: a South African database analysis

Published online by Cambridge University Press:  13 January 2010

Ilse Truter
Ilse Truter*
Affiliation:
Drug Utilization Research Unit, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
*
Correspondence should be addressed to: Professor Ilse Truter, Drug Utilization Research Unit (DURU), Department of Pharmacy, PO Box 77000, Nelson Mandela Metropolitan University, Port Elizabeth, 6031South Africa. Phone: +27-41-504 2131 or +27-41-504 2128; Fax: +27-41-504 2744. Email: ilse.truter@nmmu.ac.za or ilse.truter@gmail.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Relatively few studies of mental illness in Africa have focused on dementia. The primary aim of this study was to determine the prescribing patterns and cost of drugs for Alzheimer's disease in a private health care sector patient population.

Methods: A retrospective, exposure-cohort pharmacoepidemiological study was conducted. Data were obtained from a South African private pharmacy group for 2008. The database consisted of 1,578,346 medicine records.

Results: A total of 588 patients (326 females and 262 males) received 2623 medicine items for Alzheimer's disease at a cost of R1,563,701.18 (average cost per item R596.15). The average age of the patients was 75.54 (SD = 10.48) years. Donepezil was the most frequently prescribed active ingredient (37.09%), followed by galantamine (36.94%). Donepezil accounted for 39.50% of the cost of Alzheimer medication. The average cost per prescription was R634.76 for donepezil and R551.35 for memantine. Only 5.27% of patients were prescribed more than one active ingredient for Alzheimer's disease during the year (mostly donepezil or galantamine, and memantine). Average prescribed daily doses (PDDs) of all active ingredients were generally lower than their respective defined daily doses (DDDs). The average PDD for donepezil was 7.45 mg (DDD = 7.5 mg), for galantamine 13.56 mg (DDD = 16 mg), for memantine 17.46 mg (DDD = 20 mg) and for rivastigmine 6.89 mg (DDD = 9 mg).

Conclusions: A small number of patients were prescribed medicine for Alzheimer's disease. It is recommended that qualitative studies be undertaken to determine the cost-effectiveness of the different treatment options according to family members and carers.

Keywords

drug utilization studydementiaMemantineprescribing patternsSouth Africadefined daily dose (DDD)private health care sector
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 2 , March 2010 , pp. 264 - 269
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barclay, L. (2009). Cholinesterase inhibitors linked to serious adverse events in older adults with dementia. Medscape Medical News, CME/CE Activity (20 May 2009). Available at: http://www.medscape.com/viewarticle/703039 (last accessed 28 May 2009).Google Scholar
Beers, M. H. et al. (eds.). (2006). The Merck Manual of Diagnosis and Therapy. 18th edn.Whitehouse Station, NJ: Merck Research Laboratories.Google Scholar
Capellà, D. (1993). Descriptive tools and analysis. In Dukes, M. N. G. (ed.), Drug Utilization Studies: Methods and Uses (pages 55–78). Copenhagen: WHO Regional Publications, European Series No. 45.Google Scholar
Chandra, V. et al. (1994). Studies of the epidemiology of dementia: comparisons between developed and developing countries. Aging: Clinical and Experimental Research, 6, 307–321.Google ScholarPubMed
Gibbon, C. J. (ed.) (2008). South African Medicines Formulary. 8th edn.Cape Town: Health and Medical Publishing Group of the South African Medical Association.Google Scholar
Gill, S. S. et al. (2009). Syncope and its consequences in patients with dementia receiving cholinesterase inhibitors: population-based cohort study. Archives of Internal Medicine, 169, 867–873.CrossRefGoogle ScholarPubMed
Ineichen, B. (1996). The prevalence of dementia and cognitive impairment in China. International Journal of Geriatric Psychiatry, 11, 695–697.3.0.CO;2-M>CrossRefGoogle Scholar
Ineichen, B. (2000). The epidemiology of dementia in Africa: a review. Social Science and Medicine, 50, 1673–1677.CrossRefGoogle ScholarPubMed
MediFile (2006). Memantine in Alzheimer's disease.MediFile: Drug Information Bulletin, 9, 37–40, Johannesburg: MediKredit.Google Scholar
Möbius, H. J. (2003). Memantine: update on the current evidence. International Journal of Geriatric Psychiatry, 18, S47–S54. doi:10.1002/gps.939.CrossRefGoogle ScholarPubMed
NICE (2007). Donepezil, Galantamine, Rivastigmine (Review) and Memantine for the Treatment of Alzheimer's Disease (Amended). Quick Reference Guide. London: National Institute for Health and Clinical Excellence.Google Scholar
Snyman, J. R. (ed.) (2007). Mims Medical Specialities. Vol. 47, Saxonwold: MIMS.Google Scholar
WHO Collaborating Centre (2009). ATC/DDD Index 2009. WHO Collaborating Centre for Drug Statistics Methodology. Available at: http://www.whocc.no/atcddd/indexdatabase (last accessed 23 April 2009).Google Scholar