School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Department of Statistics, Faculty of Science, The University of Auckland, Auckland, New Zealand.
Aust N Z J Psychiatry. 2023 Jun;57(6):895-903. doi: 10.1177/00048674221121091. Epub 2022 Sep 2.
Anti-dementia medications such as acetylcholinesterase inhibitors are an important part of the management pathway for dementia. However, there are limited data in New Zealand that have examined the rates and patterns of use of funded anti-dementia medication and how use differs with ethnicity, age and sex.
This was a retrospective population-based descriptive study. Using the Integrated Data Infrastructure, we identified individuals of all ages coded for a diagnosis of dementia and estimated the proportion dispensed funded anti-dementia medication - donepezil tablets and rivastigmine patches - between 1 July 2016 and 30 June 2020. Rates of medication use in five main ethnic groups (Māori, Pacific peoples, Asian, European, and Middle Eastern, Latin American and African) in the <65, 65-79 and 80 and over (80+) age groups were compared and also between males and females in all sub-groups. Log-binomial models were used to calculate relative risks to determine any differences in anti-dementia medication use in the five ethnic groups and the three age groups and between males and females in each of the four study years.
Overall, one-third of the dementia population received a funded anti-dementia medication in the total population (all ages) between 2016 and 2020. Donepezil tablets were dispensed in 31.6-34.0% and rivastigmine patches in 1.4-2.1% across the four study years. Compared to people of European ethnicity, Māori, Pacific peoples, and Middle Eastern, Latin American and African groups were less likely to be dispensed an anti-dementia medication (Māori: relative risk = 0.79-0.81, < 0.0001; Pacific peoples: relative risk = 0.72-0.74, < 0.0001; Middle Eastern, Latin American and African: relative risk = 0.73-0.78, < 0.05). Compared to the age 80+ group, the 65-79 age group was more likely (relative risk = 1.50-1.54, < 0.0001), while the age <65 group was less likely (relative risk = 0.67-0.71, < 0.0001) to be dispensed an anti-dementia medication. There were no statistically significant differences in anti-dementia medication use between males and females.
This study provides important information about funded anti-dementia medication use in New Zealand and how this differs by ethnicity, age and sex. Despite higher dementia prevalence in Māori and Pacific peoples, these groups were less likely to receive funded anti-dementia medication.
乙酰胆碱酯酶抑制剂等抗痴呆药物是痴呆管理途径的重要组成部分。然而，新西兰的数据有限，尚未研究有补贴的抗痴呆药物的使用率和使用模式，以及使用情况如何因族裔、年龄和性别而有所不同。
这是一项回顾性基于人群的描述性研究。我们使用综合数据基础设施，确定了所有年龄均被诊断为痴呆症的患者，并估计了 2016 年 7 月 1 日至 2020 年 6 月 30 日期间使用有补贴的抗痴呆药物（多奈哌齐片和利伐斯的明贴片）的比例。在<65、65-79 和 80 岁及以上年龄组中，比较了五个主要族裔群体（毛利人、太平洋岛民、亚洲人、欧洲人和中东、拉丁美洲和非洲人）的药物使用率，并在所有亚组中比较了男性和女性之间的药物使用率。使用对数二项式模型计算相对风险，以确定五个族裔群体和三个年龄组中抗痴呆药物使用情况的差异，以及每个研究年男性和女性之间的差异。
总体而言，2016 年至 2020 年间，三分之一的痴呆症患者在总人口（所有年龄段）中接受了有补贴的抗痴呆药物治疗。四年来，多奈哌齐片的使用率为 31.6%-34.0%，利伐斯的明贴片的使用率为 1.4%-2.1%。与欧洲族裔相比，毛利人、太平洋岛民和中东、拉丁美洲和非洲群体接受抗痴呆药物治疗的可能性较低（毛利人：相对风险=0.79-0.81，<0.0001；太平洋岛民：相对风险=0.72-0.74，<0.0001；中东、拉丁美洲和非洲：相对风险=0.73-0.78，<0.05）。与 80 岁以上年龄组相比，65-79 岁年龄组更有可能（相对风险=1.50-1.54，<0.0001），而<65 岁年龄组则不太可能（相对风险=0.67-0.71，<0.0001）接受抗痴呆药物治疗。男性和女性之间使用抗痴呆药物没有统计学上的显著差异。
本研究提供了有关新西兰有补贴的抗痴呆药物使用情况以及该情况如何因族裔、年龄和性别而异的重要信息。尽管毛利人和太平洋岛民的痴呆症患病率较高，但这些群体接受有补贴的抗痴呆药物治疗的可能性较低。
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