治疗阿尔茨海默病的药物处方：南非数据库分析。

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

机构信息

Drug Utilization Research Unit, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa.

出版信息

Int Psychogeriatr. 2010 Mar;22(2):264-9. doi: 10.1017/S1041610209991530. Epub 2010 Jan 13.

DOI:10.1017/S1041610209991530

PMID:20067653

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.

摘要

背景

在非洲，针对精神疾病的研究相对较少，其中痴呆症是研究重点。本研究的主要目的是确定在私营医疗保健部门患者群体中，治疗阿尔茨海默病的药物处方模式和成本。

方法

这是一项回顾性、暴露队列药物流行病学研究。数据来自于南非一家私营药房集团，时间为 2008 年。数据库包含 1578346 份药物记录。

结果

共有 588 名患者（326 名女性和 262 名男性）接受了用于治疗阿尔茨海默病的 2623 种药物，总费用为 1563701.18 兰特（每种药物的平均费用为 596.15 兰特）。患者的平均年龄为 75.54 岁（标准差=10.48）。多奈哌齐是最常开的活性成分（37.09%），其次是加兰他敏（36.94%）。多奈哌齐占阿尔茨海默病药物治疗费用的 39.50%。多奈哌齐的每张处方平均费用为 634.76 兰特，美金刚的平均费用为 551.35 兰特。在这一年中，只有 5.27%的患者同时开了两种以上用于治疗阿尔茨海默病的活性成分（主要是多奈哌齐或加兰他敏和美金刚）。所有活性成分的平均处方日剂量（PDD）通常低于各自的限定日剂量（DDD）。多奈哌齐的平均 PDD 为 7.45 毫克（DDD=7.5 毫克），加兰他敏为 13.56 毫克（DDD=16 毫克），美金刚为 17.46 毫克（DDD=20 毫克），利伐斯的明为 6.89 毫克（DDD=9 毫克）。