Author contribution. Study concept and design: Franchi, Lucca, Nobili, Pasina, Riva, and Tettamanti. Acquisition of data: Bortolotti, Fortino, Franchi, and Merlino. Analysis and interpretation of data: Franchi, Lucca, Nobili, Pasina, Riva, and Tettamanti. Drafting the manuscript: Franchi, Lucca, and Nobili. Critical review of the manuscript: Nobili, Franchi, Lucca, Tettamanti, Bortolotti, Fortino, Merlino, Pasina, and Riva.
Cholinesterase inhibitor use in Alzheimer's disease: the EPIFARM-Elderly Project†
Article first published online: 23 MAR 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 20, Issue 5, pages 497–505, May 2011
How to Cite
Franchi, C., Lucca, U., Tettamanti, M., Riva, E., Fortino, I., Bortolotti, A., Merlino, L., Pasina, L. and Nobili, A. (2011), Cholinesterase inhibitor use in Alzheimer's disease: the EPIFARM-Elderly Project. Pharmacoepidem. Drug Safe., 20: 497–505. doi: 10.1002/pds.2124
- Issue published online: 23 MAR 2011
- Article first published online: 23 MAR 2011
- Manuscript Accepted: 4 FEB 2011
- Manuscript Revised: 31 JAN 2011
- Manuscript Received: 31 AUG 2010
- Regional Health Ministry of Lombardy Region
- Milano Naviglio Grande San Carlo
- Milano Scala
- Inner Wheel Milano San Carlo
- drug utilization study;
- cholinesterase inhibitors;
- Alzheimer's disease
This study was designed to examine the prevalence of cholinesterase inhibitor (ChEI) use and the proportions of patients treated with ChEIs by using an administrative prescription database of prevalent and incident cases of mild to moderate Alzheimer's disease (AD) in relation to age and duration of therapy.
A prospective observational study covering individuals aged 65 years or older who received at least one prescription of ChEIs between 1 January 2002 and 31 December 2007 was conducted in three health administrative areas in the Lombardy Region, Italy.
The prevalence of those who received at least one prescription for ChEIs rose from 0.5% in 2002 to 0.7% in 2004, reaching a plateau. Among estimated prevalent cases of mild to moderate AD, the prevalence of patients who received at least one prescription of ChEIs varied in different age groups, rising in those over 80 years and falling slightly in those under 80 years, particularly in patients aged 65–69 years (test for trend, p < 0.001). Among estimated incident cases, the percentage of newly treated patients dropped from 12% in 2004 to 8% in 2007, as well as within each age group (test for trend, p < 0.001). In the cohort of incident users, nearly 40% of patients who started treatment in 2004 were still in treatment 3 years later.
The prescription prevalence of ChEIs increased up to 2004, then reached a plateau. This might reflect the practical response of physicians and patients to the controversy and uncertainty surrounding the clinical value of these expensive drugs for the treatment of AD. Copyright © 2011 John Wiley & Sons, Ltd.