title: Antidementia drug treatment in dementia networks in Germany: use rates and factors associated with treatment use.
abstract: BACKGROUND
  Dementia networks in Germany constitute a specialised setting for integrated dementia care and have shown benefits on relevant outcomes, including those of drug treatment. National guidelines recommend treatment with acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) or the N-Methyl-D-Aspartate antagonist (memantine) to reduce cognitive symptoms. However, prescription rates are lower than 30 % in general practises. This study aims to describe antidementia drug treatment and the factors that are associated with the treatment in different dementia networks across Germany.
  
  
  METHODS
  We have analysed the socio-demographic, clinical and utilisation data from 560 patients with dementia (PWD), as well as data from their caregivers, in 13 selected dementia networks in Germany. The patients and caregivers were interviewed in their homes or in the network facilities. Multiple logistic regression models were fitted to evaluate the socio-demographic and clinical factors associated with the utilisation of antidementia drug treatment in the various networks.
  
  
  RESULTS
  In all of the networks in the study, 52 % of the participants received an antidementia drug treatment. Factors associated with the utilisation of the antidementia drug treatment were: formal diagnosis (OR = 16.81, p < 0.001), association with a physician in the network (OR = 3.69, p < 0.001), higher number of comorbidities (OR = 0.88, p = 0.039), living alone (OR = 0.51, p = 0.032) and higher age (OR = 2.97, p = 0.002).
  
  
  CONCLUSIONS
  Medical treatment of PWD with antidementia drugs in dementia networks in Germany is more frequent than in primary and nursing home care settings. Our findings also suggest that participants with a formal diagnosis and a physician in the network have increased rates of receiving antidementia drug treatments. These findings suggest that dementia networks focusing on medical treatment should support diagnostic procedures and incorporate physician specialists.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Research Group "Interventional Health Care Research", Site Rostock/Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. markus.wuebbeler@dzne.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Wübbeler
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. diana.wucherer@dzne.de.
authors.forename: Diana
authors.initials: D
authors.lastname: Wucherer
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. Johannes.Hertel@dzne.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hertel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. Bernhard.Michalowsky@dzne.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalowsky
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Research Group "Care Structures" Site Witten, Stockumer Str. 12, Witten, D-58453, Germany. steffen.heinrich@dzne.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Heinrich
authors.affiliation: Department of Human and Health Science, University of Bremen, Grazer Str. 4, Bremen, D-28359, Germany. saskia.meyer@uni-bremen.de.
authors.forename: Saskia
authors.initials: S
authors.lastname: Meyer
authors.affiliation: Institute for Applied Social Sciences, Rotebühlstr. 131, Stuttgart, D-70197, Germany. s.schaefer-walkmann@ifas-stuttgart.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Schaefer-Walkmann
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. wolfgang.hoffmann@uni-greifswald.de.|Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Ernst-Moritz-Arndt-University Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. wolfgang.hoffmann@uni-greifswald.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Research Group "Interventional Health Care Research", Site Rostock/Greifswald, Ellernholzstr. 1-2, Greifswald, D-17487, Germany. rene.thyrian@dzne.de.
authors.forename: Jochen René
authors.initials: JR
authors.lastname: Thyrian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D002800:Cholinesterase Inhibitors; D003704:Dementia / Q000188:drug therapy*; D000077265:Donepezil; D015259:Dopamine Agents / Q000008:administration & dosage; D005260:Female; D005702:Galantamine / Q000008:administration & dosage; D005858:Germany; D006801:Humans; D007189:Indans / Q000008:administration & dosage; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008559:Memantine / Q000008:administration & dosage; D018696:Neuroprotective Agents / Q000008:administration & dosage; D018697:Nootropic Agents / Q000008:administration & dosage*; D010880:Piperidines / Q000008:administration & dosage; D000068836:Rivastigmine / Q000008:administration & dosage
chemical_list: D002800:Cholinesterase Inhibitors; D015259:Dopamine Agents; D007189:Indans; D018696:Neuroprotective Agents; D018697:Nootropic Agents; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine; D008559:Memantine