[Acetylcholinesterase inhibitor treatment for Alzheimer's disease: the experience in Picardy]. / Traitement anticholinestérasique de la maladie d'Alzheimer en Picardie.

ABSTRACT

INTRODUCTION: Despite numerous advances in the management of patients with Alzheimer's disease (AD), the proportion of patients treated according to current recommendations remains unknown. METHODS: In order to examine this point, we performed a study assessing the proportion of AD patients receiving one acetylcholinesterase inhibitor. This study was performed in Picardy (1.9 millions of inhabitants) in 2000 and 2001. The number of patients receiving one acetylcholinesterase inhibitor (tacrine, donepezil, rivastigmine and galantamine) was determined using data from health insurance and from pharmaceutical companies. RESULTS: The prevalence of AD was estimated to vary from 10751 patients in 2000, to 10990 in 2001. The number of treated patients was 1798 in 2000 and 2572 in 2001 and this corresponded to 16.7 percent (95CI 2.5) and 23.4 percent (95CI 3.4) of prevalent cases, respectively. Following the exclusion of patients with moderate to severe AD (estimated to represent 25 percent of patients), the proportion of treated patients reached 22.4 percent (95CI 2.3) in 2000 and 31.3 percent (95CI 3.1) in 2001. CONCLUSIONS: Despite a significant increase between 2000 and 2001, this study shows that less than a third of AD patients with mild to moderate dementia were treated with acetylcholinesterase inhibitors. Although numerous factors might have affected our estimations, this study shows that effective care of AD patients remains largely insufficient.