title: [Changes in drug management of Alzheimer's disease in nursing homes: Impact of the media campaign against specific drugs for Alzheimer's disease].
abstract: BACKGROUND
  Alzheimer's disease is a common disease in nursing homes. Evolution is constantly negative and specific treatments, which are only symptomatic, are subject to controversy. In a context of media exposure, the Transparency Committee of the Haute Autorité de santé (HAS) downgraded their medical service in October 2011, seeing it as weak.
  
  
  OBJECTIVE
  Assess the evolution of the consumption of specific treatments for Alzheimer's disease; assess changes in the quality of monitoring in specific consultation.
  
  
  METHODS
  This is a retrospective and descriptive study, cross-sectional in three times (T0 January 2011, T1 October 2011 and T2 June 2012), in 6 nursing homes of Lille and its surroundings.
  
  
  RESULTS
  In total, 262 residents with dementia and present at least once during the three times of the study were included. Their mean age was 85.8 years. Among them, 40 % had Alzheimer's disease clearly identified. At T0, 76.7 % of patients present who were supposed to receive a specific treatment of Alzheimer's disease were actually receiving such treatment, 73.6 % at T1 and 71.6 % at T2. After 17 months of observation, the discontinuation rate of anticholinesterase was 34 %, 24 % for anti-glutamate. The monitoring in specific consultations decreased slightly between the three stages.
  
  
  CONCLUSIONS
  Our work did not show major impact of the media campaign against specific drugs for Alzheimer's disease. There is however a trend towards a decrease of their consumption in people with dementia living in nursing homes with no obvious link between monitoring in specific consultation and specific prescription. This trend would ask to be confirmed by a study on a larger scale.
authors.affiliation: Service de médecine gériatrique, centre hospitalier de Roubaix, 59100 Roubaix, France. Electronic address: aemiliepetit@hotmail.fr.
authors.forename: A-E
authors.initials: AE
authors.lastname: Petit
authors.affiliation: Service de médecine gériatrique, centre hospitalier de Tourcoing, 59200 Tourcoing, France.
authors.forename: H
authors.initials: H
authors.lastname: Mangeard
authors.affiliation: EA 2694 - Santé publique : épidémiologie et qualité des soins, université de Lille, 59000 Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Chazard
authors.affiliation: Hôpital gériatrique « Les Bateliers », CHRU de Lille, 59000 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Puisieux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003146:Communications Media; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D005602:France / Q000453:epidemiology; D006293:Health Promotion / Q000379:methods; D006707:Homes for the Aged / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008297:Male; D008510:Medication Systems, Hospital / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards; D012189:Retrospective Studies
chemical_list: D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists
keywords: Alzheimer's disease; Anti-cholinestérasiques; Cholinesterase inhibitors; EHPAD; Maladie d’Alzheimer; Nursing home