Cholinesterase inhibitors for Alzheimer's disease: variations in clinical practice in the north‐west of England

International Journal of Geriatric Psychiatry - Tập 21 Số 10 - Trang 961-964 - 2006
Nitin Purandare1, Caroline Swarbrick1, Alastair Fischer2, Alistair Burns1
1Department of Psychiatary, University of Manchester, Manchester, UK
2Health Economics, St George's, University of London, London, UK

Tóm tắt

AbstractBackgroundIn the UK, the National Institute for Health and Clinical Excellence (NICE) is currently reviewing cost‐effectiveness of cholinesterase inhibitors (ChEIs) for Alzheimer's disease (AD) in the NHS. The implementation of the original NICE (2001) guidance that made these drugs available in the UK was not examined in this review process, and was the objective of this study.MethodTen hospitals in and around Manchester participated in the audit. Case records of all patients who were started on ChEIs between January 2002 and the date of the audit (November 2003 to December 2004) were examined to assess adherence to the NICE (2001) guidance. Information about available resources was gathered from lead clinicians of each hospital.ResultsA total of 1092 case records were examined. The treatment of AD with ChEIs varied considerably with regard to pre‐treatment investigations, waiting period for treatment, scales used to assess efficacy, adherence to the NICE (2001) guidance, and available resources. The actual number of patients with mild to moderate AD receiving ChEIs was much lower than that expected from known prevalence rates. Non‐uniformity of clinical practice and missing data were the main limitations of the audit.ConclusionThere is a need to harmonise the use and monitoring of ChEIs for AD in the NHS so that the data from routine clinical practice could feed into future clinical and cost‐effectiveness analyses. Copyright © 2006 John Wiley & Sons, Ltd.

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Thông tin xuất bản

International Journal of Geriatric Psychiatry

Tập 21 Số 10

961-964

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