Kumar Ct Sudhir, Varghese Mathew, Duddu Venugopal, Vaitheswaran Sridhar, Srivastava Shrikant, Shaji K S, George Sanju, Singh Narendra Kumar, Goyal Nishant, Bakhla Ajay, Shaji S, Menon Vikas, Hussain Tajamul, Grover Sandeep, Mehra Aseem, Singh Lokesh Kumar, Purushotham A, Desousa Avinash, Shah Nilesh, Karia Sagar, Anand I, Afroon Shafana, Mehta Ritambhara, Kukreja Gargi, Dadarwala Dimple, Vidya K L, Sivakumar P T, Sinha Preeti, Reddy Shivashankar, Isaac Thomas, Chandra Mina
Alzheimer's and Related Disorders Society of India (ARDSI) - Kottayam Chapter, Aymanam, Kerala, India.
Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2023 Jan;65(1):52-60. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_736_21. Epub 2023 Jan 13.
There are more than 5 million people with dementia in India. Multicentre studies looking at details of treatment for people with dementia In India are lacking. Clinical audit is a quality improvement process which aims to systematically assess, evaluate, and improve patient care. Evaluating current practice is the key to a clinical audit cycle.
This study aimed to assess the diagnostic patterns and prescribing practices of psychiatrists for patients with dementia in India.
A retrospective case file study was conducted across several centers in India.
Information from the case records of 586 patients with dementia was obtained. Mean age of the patients was 71.14 years (standard deviation = 9.42). Three hundred twenty one (54.8%) were men. Alzheimer's disease (349; 59.6%) was the most frequent diagnosis followed by vascular dementia (117; 20%). Three hundred fifty five (60.6%) patients had medical disorders and 47.4% patients were taking medications for their medical conditions. Eighty one (69.2%) patients with vascular dementia had cardiovascular problems. Majority of the patients (524; 89.4%) were on medications for dementia. Most frequently prescribed treatment was Donepezil (230; 39.2%) followed by Donepezil-Memantine combination (225; 38.4%). Overall, 380 (64.8%) patients were on antipsychotics. Quetiapine (213, 36.3%) was the most frequently used antipsychotic. Overall, 113 (19.3%) patients were on antidepressants, 80 (13.7%) patients were on sedatives/hypnotics, and 16 (2.7%) patients were on mood stabilizers. Three hundred nineteen (55.4%) patients and caregivers of 374 (65%) patients were receiving psychosocial interventions.
Diagnostic and prescription patterns in dementia which emerged from this study are comparable to other studies both nationally and internationally. Comparing current practices at individual and national levels against accepted guidelines, obtaining feedback, identifying gaps and instituting remedial measures help to improve the standard of care provided.
印度有超过500万痴呆症患者。目前缺乏针对印度痴呆症患者治疗细节的多中心研究。临床审计是一个质量改进过程，旨在系统地评估、评价并改善患者护理。评估当前的医疗实践是临床审计周期的关键。
本研究旨在评估印度精神科医生对痴呆症患者的诊断模式和处方习惯。
在印度的多个中心开展了一项回顾性病例档案研究。
获取了586例痴呆症患者的病例记录信息。患者的平均年龄为71.14岁（标准差=9.42）。其中321例（54.8%）为男性。最常见的诊断是阿尔茨海默病（349例，59.6%），其次是血管性痴呆（117例，20%）。355例（60.6%）患者患有躯体疾病，47.4%的患者正在服用治疗躯体疾病的药物。81例（69.2%）血管性痴呆患者患有心血管问题。大多数患者（524例，89.4%）正在服用治疗痴呆症的药物。最常开具的治疗药物是多奈哌齐（230例，39.2%），其次是多奈哌齐-美金刚联合用药（225例，38.4%）。总体而言，380例（64.8%）患者使用了抗精神病药物。喹硫平（213例，36.3%）是最常用的抗精神病药物。总体而言，113例（19.3%）患者使用了抗抑郁药，80例（13.7%）患者使用了镇静催眠药，16例（2.7%）患者使用了心境稳定剂。319例（55.4%）患者以及374例（65%）患者的照护者接受了心理社会干预。
本研究中出现的痴呆症诊断和处方模式与国内和国际上的其他研究相当。将个体和国家层面的当前实践与公认的指南进行比较、获取反馈、找出差距并采取补救措施，有助于提高所提供的护理标准。
