Treatment disparities in medication prescribing for Alzheimer's: disease among ethnic groups

J Health Care Finance. 2009 Summer;35(4):64-73.

Abstract

Objectives: The purpose of this explanatory study was to determine whether medication prescribing for Alzheimer's disease (AD) differs by racial and ethnic group membership. The following research question was examined in this study: Are there prescribing pattern differences for AD among racial and ethnic groups? Additional beneficiary characteristic variables examined included: diabetes, memory loss, psychological disorder, age category, and gender.

Methods: This research project employed a time series study design to analyze three years of a national secondary dataset to examine Medicare beneficiaries with Alzheimer's disease (AD). Specific medications were identified as the standard of care treatment regimen for severe and mild to moderate AD (Aricept and Exelon, respectively).

Results: Descriptive statistics for medications for the AD group were obtained. Total prescribed medications for the AD group was analyzed for treatment differences for the study variables race, age category, gender, psychological disorder, diabetes, and memory loss. An association was found for all three years between treatment (Aricept) and the following variables: diabetes, memory loss, and psychological disorder.

Discussion: Treatment type trends indicated that Aricept use for both blacks and whites has decreased. High frequency of antiseizure medications were found, which could indicate their use as mood enhancers. Study findings indicate that patients on AD treatment were not also taking mood enhancers. Diabetic patients were found to be on Aricept and Exelon and mood altering medications. Hormones were present among the medications; since the sample was over 65 (post menopausal), could indicate use of hormone therapy as a treatment option for this sample despite standard treatment recommendations.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / ethnology*
  • Cholinesterase Inhibitors / therapeutic use
  • Donepezil
  • Female
  • Healthcare Disparities*
  • Humans
  • Indans / therapeutic use
  • Male
  • Medicare / statistics & numerical data*
  • Piperidines / therapeutic use
  • Practice Patterns, Physicians'
  • Severity of Illness Index
  • Sex Factors
  • United States

Substances

  • Cholinesterase Inhibitors
  • Indans
  • Piperidines
  • Donepezil