Pharmacological treatment strategies of residential primary care providers in dementia diseases--results of a representative survey in western Austria.
OBJECTIVE
The goal of this study was to investigate pharmacological treatment strategies used by residential primary care providers for patients with dementia.


METHODS
A postal questionnaire survey was sent to all residential primary care providers, internists, neurologists and psychiatrists (n = 689) in the western region of Austria.


RESULTS
The response rate (53 %) was similar in all four physician groups. Acetylcholinesterase inhibitors are considered to have a higher efficacy (p < 0.0005) compared to nootropic drugs. However, the vast majority of primary care providers (95 %) prescribe nootropic drugs. Two thirds (64 %) of the primary care providers prescribe acetylcholinesterase inhibitors. The dementia subtype influences the prescription frequency of acetylcholinesterase inhibitors, but not the specific choice of nootropic compound. Half of the primary care providers (52 %) combine antidementia drugs. Nearly two-thirds (62 %) of all primary care providers frequently prescribe antidepressants. Specific serotonin reuptake inhibitors are applied by the majority of primary care providers (96 %). About one-third (39 %) of primary care providers and internists (29 %) prescribe tricyclic antidepressants. Antipsychotics are applied frequently by around a quarter (29 %) of all physicians. More than half of primary care providers (62 %) and internists (58 %) treat patients with typical antipsychotics. Psychiatrists and neurologists are significantly more reluctant to prescribe tricyclic antidepressants and typical antipsychotics.


CONCLUSIONS
Despite the lack of scientific evidence, residential primary care providers combine antidementia drugs very frequently. Therefore, controlled studies on combination therapies are urgently needed; in contrast to neurologists and psychiatrists, primary care providers and internists frequently prescribe tricyclic antidepressants and typical antipsychotics. The reasons for this should be clarified in further studies.
Gurka
P
P
Department of Psychiatry, Anichstrasse 35, 6020 Innsbruck, Austria.
Bacher
R
R
Kemmler
G
G
Hinterhuber
H
H
Lingg
A
A
Marksteiner
J
J
D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001317:Austria; D003704:Dementia / Q000188:drug therapy*; D011307:Drug Prescriptions; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D009462:Neurology / Q000706:statistics & numerical data; D018697:Nootropic Agents / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018697:Nootropic Agents