Dados do Trabalho

Título

Analysis of the distribution of drugs for dementia due to Alzheimer's disease in the state of Rio Grande do Sul.

Resumo

Introduction: Drugs for dementia due to Alzheimer's disease (AD) have been part of the SUS Specialized Pharmaceutical Care Component (SPCC) since 2005 and are provided free of charge as long as the request for these drugs meets the criteria of the national guidelines. Assessing the profile of this distribution can reveal inequalities in the supply of these drugs and, indirectly, in the quality of care for Alzheimer's patients. Objectives: To evaluate the prescription pattern and the profile of patients who receive prescription of medication for AD in the state of RS. Methods: All approved requests for donepezil, rivastigmine, galantamine, and memantine for the SPCC in the state of RS between July and November 2021 were evaluated. Patients' sociodemographic data, scores on the Mini Mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR), type and dose of the prescribed medication, municipality and health macro-region of origin were obtained. In addition, the human development index (HDI) and the prescription index (patients/100,000 population) of each macro-region were associated. Results: In the second half of 2021, 2382 AD patients were receiving some specific AD medication in RS. Most were female (65.5%) and the median age (interquartile range - IQR) was 79 (73.5-84) years. Most patients had education less than 8 years (n=1266; 71.7%). The median MMSE score was 15 (12-18) and most had CDR 2 (47.5%) or 1 (34.8%). In most municipalities, 339 (68.2%), there were patients with some prescription. The macro-regions “Serra” (37/100,000) and Norte (33/100,000) had higher prescription indices and the Sul region had the lowest (7/100,000). There was a strong correlation between prescription index and HDI (Rho=0.877; p<0.009, Spearman). The most prescribed drugs were donepezil (n=1014; 42.6%) and rivastigmine (n=691; 29%), and 464 (19.5%) patients were using memantine association. The “Centro-Oeste” macro-region showed a higher frequency of patients with CDR=2 (61.2%) and a higher frequency of rivastigmine prescriptions (42.1%) compared to other regions. Conclusions: The analysis of the profile of patients with AD who receive medication for the disease in the state of RS reveals some inequality, with less developed regions showing lower frequency of prescription, and prescription for patients in more advanced stages.