Methods: We considered the monthly proportion of patients eligible for treatment, with a diagnosis of probable Alzheimer’s disease, receiving their first prescription for each drug class – namely acetylcholinesterase (AChE) inhibitors (donepezil, rivastigmine, galantamine) and N-Methyl-D-aspartate (NMDA) receptor antagonists (memantine). Trend analysis using joinpoint models was then applied to identify up to two trend changes per treatment of interest.
Results: The overall trend was for increasing prescriptions in each drug class over the period they were studied. This was indicated by the average monthly percentage change, which was 6.0% (95% CI: -6.4 to 19.9; June 1997 to December 2015) for AChE inhibitors and 15.4% (95% CI: -77.1 to 480.9; January 2003 to December 2015) for NMDA receptor antagonists. Prescriptions of AChE inhibitors increased at the end of 2012, probably in response to the patent expiry of these drugs earlier that year. The Prime Minister’s Dementia Challenge launched in May 2012 may also have contributed to the observed increase. However, neither this strategy nor patent expiry appeared to influence prescriptions of NMDA receptor antagonists. Instead trend changes in this drug class were driven by NICE guidance released in 2011 that allowed access to these drugs outside of clinical trials.
Conclusions: Dementia drug prescribing does not always respond to factors such as regulatory guidance, recommendations or patent expiry and, when it does, not necessarily in a predictable way. This suggests that improved communication with clinicians may be needed to improve the cost-effective use of drugs for dementia.
|Number of pages||11|
|Journal||Alzheimer's Research and Therapy|
|Publication status||Published - 29 May 2018|
- Alzheimer Disease
- Clinical Practice Research Datalink
- National Institute of Health and Clinical Excellence
- Quality and Outcomes Framework
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New uses for old drugs : Investigating whether antihypertensives can be repurposed for the prevention of dementiaAuthor: Walker, V., 13 Sept 2019
Supervisor: Davies, N. (Supervisor), Kehoe, P. (Supervisor) & Martin, R. (Supervisor)
Student thesis: Doctoral Thesis › Doctor of Philosophy (PhD)File
CPRD codes: ICD-10 equivalent code lists for dementia subtypes
Walker, V. M. (Creator), Davies, N. (Creator), Kehoe, P. G. (Creator), Martin, R. M. (Creator) & Payne, R. (Data Manager), University of Bristol, 27 Nov 2017
DOI: 10.5523/bris.2h4rmk9v7pw2k23h7vgf9tx1ea, http://data.bris.ac.uk/data/dataset/2h4rmk9v7pw2k23h7vgf9tx1ea
CPRD codes: neurodegenerative diseases and commonly prescribed drugs
Walker, V. M. (Creator), Davies, N. (Creator), Kehoe, P. G. (Creator), Martin, R. M. (Creator) & Payne, R. (Data Manager), University of Bristol, 2 Oct 2017
DOI: 10.5523/bris.1plm8il42rmlo2a2fqwslwckm2, http://data.bris.ac.uk/data/dataset/1plm8il42rmlo2a2fqwslwckm2