Isabella Boroje, Olga Sánchez-Soliño, Emma Xiaomeng Yue, Lisa Vinikoor-Imler
{"title":"轻度认知障碍和阿尔茨海默病患者的药物处方:一项大型全国电子健康记录队列研究","authors":"Isabella Boroje, Olga Sánchez-Soliño, Emma Xiaomeng Yue, Lisa Vinikoor-Imler","doi":"10.1177/13872877251376032","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundCholinesterase inhibitors (ChE-Is), including donepezil, rivastigmine, and galantamine, and the N-methyl-D-aspartate receptor antagonist, memantine, are prescribed to decrease cognitive impairment symptoms.ObjectiveThis study examined prescriptions among patients with mild cognitive impairment (MCI) and/or Alzheimer's disease (AD) in the US by age, sex, and race/ethnicity.MethodsThis retrospective cohort study used Optum's de-identified Market Clarity Data containing electronic health records and insurance claims from January 2017 to September 2021. International Classification of Diseases, Ninth and Tenth Revisions diagnosis codes identified MCI and AD cases. Drug prescriptions were identified before, on, or after the date of first diagnosis. Cases were required to have ≥12 months of database enrolment prior to first diagnosis. Descriptive statistics were stratified by demographic groups.ResultsDuring the study period, 197,346 MCI and 144,321 AD cases were identified. Prescriptions were highest in patients with MCI aged 75-84 years before and after diagnosis for ChE-Is (8.1%, 20.4%) and memantine (2.6%, 7.8%) and among patients with AD aged 65-74 years for ChE-Is (25.0%, 38.7%) and memantine (11.2%, 22.1%). After AD diagnosis, the ChE-I prescriptions ranged from 31.3% of African American patients to 34.1% of Asian patients, and from 13.7% of African American patients to 18.5% of Hispanic patients for memantine.ConclusionsChE-I and memantine prescriptions generally increased to a certain age and were similar across sex and race/ethnicity groups. This information helps understand current prescriptions and how best to optimize in all demographic groups.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877251376032"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medication prescriptions among patients with mild cognitive impairment and Alzheimer's disease: A large nationwide electronic health record cohort study.\",\"authors\":\"Isabella Boroje, Olga Sánchez-Soliño, Emma Xiaomeng Yue, Lisa Vinikoor-Imler\",\"doi\":\"10.1177/13872877251376032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundCholinesterase inhibitors (ChE-Is), including donepezil, rivastigmine, and galantamine, and the N-methyl-D-aspartate receptor antagonist, memantine, are prescribed to decrease cognitive impairment symptoms.ObjectiveThis study examined prescriptions among patients with mild cognitive impairment (MCI) and/or Alzheimer's disease (AD) in the US by age, sex, and race/ethnicity.MethodsThis retrospective cohort study used Optum's de-identified Market Clarity Data containing electronic health records and insurance claims from January 2017 to September 2021. International Classification of Diseases, Ninth and Tenth Revisions diagnosis codes identified MCI and AD cases. Drug prescriptions were identified before, on, or after the date of first diagnosis. Cases were required to have ≥12 months of database enrolment prior to first diagnosis. Descriptive statistics were stratified by demographic groups.ResultsDuring the study period, 197,346 MCI and 144,321 AD cases were identified. Prescriptions were highest in patients with MCI aged 75-84 years before and after diagnosis for ChE-Is (8.1%, 20.4%) and memantine (2.6%, 7.8%) and among patients with AD aged 65-74 years for ChE-Is (25.0%, 38.7%) and memantine (11.2%, 22.1%). After AD diagnosis, the ChE-I prescriptions ranged from 31.3% of African American patients to 34.1% of Asian patients, and from 13.7% of African American patients to 18.5% of Hispanic patients for memantine.ConclusionsChE-I and memantine prescriptions generally increased to a certain age and were similar across sex and race/ethnicity groups. This information helps understand current prescriptions and how best to optimize in all demographic groups.</p>\",\"PeriodicalId\":14929,\"journal\":{\"name\":\"Journal of Alzheimer's Disease\",\"volume\":\" \",\"pages\":\"13872877251376032\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Alzheimer's Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/13872877251376032\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Alzheimer's Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13872877251376032","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
胆碱酯酶抑制剂(ChE-Is),包括多奈哌齐、利瓦斯蒂明和加兰他明,以及n -甲基- d -天冬氨酸受体拮抗剂美金刚,被用于减少认知障碍症状。目的:本研究按年龄、性别和种族/民族对美国轻度认知障碍(MCI)和/或阿尔茨海默病(AD)患者的处方进行调查。方法本回顾性队列研究使用Optum的去识别市场清晰度数据,其中包含2017年1月至2021年9月的电子健康记录和保险索赔。《国际疾病分类》第九版和第十版诊断代码确定了MCI和AD病例。在首次诊断之前、当天或之后确定药物处方。病例需要在首次诊断前有≥12个月的数据库登记。描述性统计按人口统计学分组分层。结果在研究期间,共发现197,346例MCI和144,321例AD病例。75-84岁MCI患者在诊断前后使用的ChE-Is(8.1%, 20.4%)和美金刚胺(2.6%,7.8%)处方最高,65-74岁AD患者使用ChE-Is(25.0%, 38.7%)和美金刚胺(11.2%,22.1%)处方最高。AD诊断后,ChE-I处方美金刚的比例从31.3%的非裔美国患者到34.1%的亚洲患者不等,从13.7%的非裔美国患者到18.5%的西班牙裔患者不等。结论sche - i和美金刚处方在一定年龄阶段普遍增加,且在性别和种族/民族之间具有相似性。这些信息有助于了解当前的处方以及如何在所有人口群体中最佳地优化处方。
Medication prescriptions among patients with mild cognitive impairment and Alzheimer's disease: A large nationwide electronic health record cohort study.
BackgroundCholinesterase inhibitors (ChE-Is), including donepezil, rivastigmine, and galantamine, and the N-methyl-D-aspartate receptor antagonist, memantine, are prescribed to decrease cognitive impairment symptoms.ObjectiveThis study examined prescriptions among patients with mild cognitive impairment (MCI) and/or Alzheimer's disease (AD) in the US by age, sex, and race/ethnicity.MethodsThis retrospective cohort study used Optum's de-identified Market Clarity Data containing electronic health records and insurance claims from January 2017 to September 2021. International Classification of Diseases, Ninth and Tenth Revisions diagnosis codes identified MCI and AD cases. Drug prescriptions were identified before, on, or after the date of first diagnosis. Cases were required to have ≥12 months of database enrolment prior to first diagnosis. Descriptive statistics were stratified by demographic groups.ResultsDuring the study period, 197,346 MCI and 144,321 AD cases were identified. Prescriptions were highest in patients with MCI aged 75-84 years before and after diagnosis for ChE-Is (8.1%, 20.4%) and memantine (2.6%, 7.8%) and among patients with AD aged 65-74 years for ChE-Is (25.0%, 38.7%) and memantine (11.2%, 22.1%). After AD diagnosis, the ChE-I prescriptions ranged from 31.3% of African American patients to 34.1% of Asian patients, and from 13.7% of African American patients to 18.5% of Hispanic patients for memantine.ConclusionsChE-I and memantine prescriptions generally increased to a certain age and were similar across sex and race/ethnicity groups. This information helps understand current prescriptions and how best to optimize in all demographic groups.
期刊介绍:
The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.