Public Health.

Area of Science:

• Neurology
• Pharmacology
• Public Health

Background:

• Low- and middle-income countries (LMICs) face challenges in dementia diagnosis and treatment.
• Brazil's Unified Health System (SUS) offers access to dementia-related medications.
• Understanding prescription patterns is crucial for optimizing dementia care in LMICs.

Purpose of the Study:

• To analyze prescription patterns of cholinesterase inhibitors, memantine, and psychotropic medications in a Brazilian outpatient memory clinic.
• To examine the combinations of these medications used in dementia patient care.
• To identify potential barriers to accessing dementia-specific therapies within the public health system.

Main Methods:

• Retrospective analysis of 280 dementia patients over 10 years at a public tertiary neurology memory clinic.
• Classification of patients into 14 groups based on prescribed pharmacological treatment.
• Assessment of demographic characteristics and Mini-Mental State Examination (MMSE) scores.

Main Results:

• Selective serotonin reuptake inhibitors (SSRIs) were most prescribed (55.1%), followed by atypical antipsychotics (AAPs) (48.2%), cholinesterase inhibitors (45.4%), and memantine (22.9%).
• SSRI monotherapy was the most common regimen (14.6%), followed by a combination of cholinesterase inhibitors, SSRIs, and AAPs (10%).
• 86.8% of patients received at least one medication, but less than 50% used dementia-specific drugs.

Conclusions:

• A high percentage of dementia patients accessed medications, but dementia-specific drug utilization was low.
• Limited use of dementia-specific medications may stem from their primary indication for Alzheimer's disease or access challenges in Brazil's SUS.
• Further research is essential to understand patient characteristics, prescription patterns, and barriers to enhance dementia care strategies.