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Drug use in patients with dementia: a register-based study in the health region of Girona (Catalonia/Spain)

European Journal of Clinical Pharmacology volume 69, pages 1047–1056 (2013)Cite this article

Abstract

Purpose

To describe the pattern of drug consumption among patients with dementia in a geographically defined general population in Catalonia (Spain), and to determine its association with age, gender, type of dementia and severity indicators.

Methods

Cross-sectional study that included 1,894 cases of dementia registered by the Registry of Dementias of Girona from 2007 to 2009. Prescribed drugs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. A descriptive analysis of drug consumption was stratified according to age, gender, dementia subtypes and dementia severity. Binary logistic regression models were adjusted to detect the association of these variables with drug consumption according to the ATC groups.

Results

The most commonly prescribed drugs were for the central nervous system (CNS) (96.4 %), cardiovascular system (79.4 %) and digestive and metabolic system categories (77.7 %). No significant differences were found between the use of nervous system drugs and age, gender, dementia subtypes or dementia severity. The use of alimentary tract and metabolism related drugs, as well as cardiovascular and blood system drugs, were positively correlated with age and secondary dementia. The prevalence of use of cardiovascular and musculoskeletal drugs was higher in women than in men (OR: 1.34; OR: 1.26 respectively). A negative association was found between the severity of dementia and the use of musculoskeletal drugs (OR: 0.71), while its use was significantly higher in the youngest patients (OR: 1.71).

Conclusions

Almost all patients with dementia received a CNS drug, being at risk of inappropriate treatment. Treatment for comorbidities in patients with dementia should not be withheld on the basis of age or dementia severity, but rather on the benefit/risk ratio of its prescription. Further studies are needed to evaluate potentially inappropriate drug use and possible untreated conditions in this population.

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Declaration of interest

The authors declare that they have no conflict of interest.

Study funding

The ReDeGi is founded by the Health Region of Girona (HRG) from the Department of Health of the Generalitat de Catalunya (Spain).

The funding source had no involvement in the decision to submit the paper for publication.

Author information

Affiliations

  1. Research Unit, Institut d’Assistència Sanitària, Girona, Spain

    Pilar Àvila-Castells, Josep Garre-Olmo, Laia Calvó-Perxas, Oriol Turró-Garriga & Secundino López-Pousa

  2. Clinical Pharmacology Section, Nursing Faculty, Universiy of Girona, Girona, Spain

    Pilar Àvila-Castells

  3. Department of Psychology, University of Girona, Girona, Spain

    Josep Garre-Olmo

  4. Dementia Unit, Hospital de Palamós, Palamós, Spain

    Elisabet Alsina

  5. Neurology Department, Hospital de Figueres, Figueres, Spain

    Olga Carmona

  6. Neurology and Geriatrics Departments, Hospital de Blanes, Blanes, Spain

    Héctor Perkal

  7. Pharmacy Unit, Health Region of Girona, Girona, Spain

    Anna Maria Roig

  8. Neurology Department, Hospital de Campdevànol, Campdevànol, Spain

    Josep Ma Cuy

  9. Dementia Unit, Hospital Santa Caterina, Salt, Spain

    Manuela Lozano & Secundino López-Pousa

  10. Department of Neurology, Hospital Universitari Josep Trueta, Girona, Spain

    Albert Molins

  11. Neurology and Geriatrics Departments, Hospital d’Olot, Olot, Spain

    Natàlia Vallmajó

  12. C/Dr Castany s/n, 17190, Salt, Girona, Spain

    Josep Garre-Olmo

Authors
  1. Pilar Àvila-Castells
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  2. Josep Garre-Olmo
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  3. Laia Calvó-Perxas
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  4. Oriol Turró-Garriga
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  5. Elisabet Alsina
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  6. Olga Carmona
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  7. Héctor Perkal
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  8. Anna Maria Roig
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  9. Josep Ma Cuy
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  10. Manuela Lozano
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  11. Albert Molins
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  12. Natàlia Vallmajó
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  13. Secundino López-Pousa
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Consortia

on behalf of the Registry Dementia of Girona Study Group

Corresponding author

Correspondence to Josep Garre-Olmo.

Additional information

The ReDeGi Group consists of the following co-investigators

1- Department of Neurology, Hospital Universitari Josep Trueta: Mar Castellanos, PhD; David Genís Batlle, MD; Jordi Gich, BPsych; Rosa Meléndez, MD; Albert Molins, MD; Lluís Ramió, MD; Joaquín Serena, PhD; Yolanda Silva, PhD.

2- Dementia Unit, Hospital Santa Caterina: Marta Hernández, BPsych; Saioa Lejarreta, MD; Manuela Lozano, BPsych; Immaculada Pericot, PhD; Joan Vilalta-Franch, PhD; Antoni Turon Estrada, PhD; Josefa Turbau, MD; Jordi Llinàs, BPsych; Secundino López-Pousa, PhD.

3- Dementia Unit, Hospital de Palamós: Elisabet Alsina, BSw; Rosa de Eugenio, MD; Erélido Hernández, MD; Margarita Flaqué, BPsych.

4- Neurology Department, Hospital de Figueres: Olga Carmona, MD; Marta Cullell, BPsych; Teresa Osuna, MD; Maria Aguirregomozcorta, MD; Mª del Mar Fernández, MD.

5- Neurology and Geriatrics Departments, Hospital d’Olot: Josep Bisbe, MD; Marta Linares, BPsych; Fabian Marquez Daniel, MD; Natalia Vallmajó, MD.

6- Neurology and Geriatrics Departments, Hospital de Blanes: Fernando Espada, MD; Teresa Casadevall, MD; Héctor Perkal, MD; Marta Viñas, MD.

7- Neurology Department; Hospital de Campdevànol: Isabel Casas, BPsych; Josefa Turbau, MD; Josep Ma Cuy, MD; Anna Manzano, MD.

8- Pharmacy Unit, Healh Region of Girona: Anna Maria Roig, BPharm; Joan Coromina, BPharm; Mònica Palacios Soto, BPharm.

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Àvila-Castells, P., Garre-Olmo, J., Calvó-Perxas, L. et al. Drug use in patients with dementia: a register-based study in the health region of Girona (Catalonia/Spain). Eur J Clin Pharmacol 69, 1047–1056 (2013). https://doi.org/10.1007/s00228-012-1451-y

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Keywords

  • Dementia
  • Ageing
  • Registries
  • Drug utilisation
  • Pharmacoepidemiology