[Order of prescribing anti-dementia drugs and antipsychotics after initial diagnosis of dementia in general and neuropsychiatric practices in Germany - a retrospective cohort study].

OBJECTIVE

To examine the prescribing sequence of anti-dementia drugs and antipsychotics after initial dementia diagnosis in general and specialist practices in Germany.

METHODS

Retrospective cohort study using the IQVIA Disease Analyzer database (1,179 general, 214 specialist practices; 2005-2024). Patients aged≥65 years with an initial dementia diagnosis,≥1 year of observation and no prior prescription were included (general: n=94,036; specialist: n=55,341).

RESULTS

In general practices, 54.2% received neither drug class, 27.3% antipsychotics only, 8.7% anti-dementia drugs only. In specialist practices, the untreated proportion was lower (22.2%); anti-dementia treatment was initiated first more often (16.0% vs. 5.6%).

CONCLUSION

Specialist practices more often initiate guideline-concordant anti-dementia treatment first; general practices show more exclusive antipsychotic prescribing and treatment forgoing.