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Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians

<p>Abstract</p> <p>Background</p> <p>Dementia is a major and increasing health problem worldwide. This study aims to investigate dementia treatment strategies among physicians specialised in complementary and alternative medicine (CAM) by analysing prescribing patterns and comparing them to current treatment guidelines in Germany.</p> <p>Methods</p> <p>Twenty-two primary care physicians in Germany participated in this prospective, multicentre observational study. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients had at least one diagnosis of dementia according to the 10th revision of the International Classification of Diseases during the study period. Multiple logistic regression was used to determine factors associated with a prescription of any anti-dementia drug including <it>Ginkgo biloba</it>.</p> <p>Results</p> <p>During the 5-year study period (2004-2008), 577 patients with dementia were included (median age: 81 years (IQR: 74-87); 69% female). Dementia was classified as unspecified dementia (57.2%), vascular dementia (25.1%), dementia in Alzheimer's disease (10.4%), and dementia in Parkinson's disease (7.3%). The prevalence of anti-dementia drugs was 25.6%. The phytopharmaceutical <it>Ginkgo biloba </it>was the most frequently prescribed anti-dementia drug overall (67.6% of all) followed by cholinesterase inhibitors (17.6%). The adjusted odds ratio (AOR) for receiving any anti-dementia drug was greater than 1 for neurologists (AOR = 2.34; CI: 1.59-3.47), the diagnosis of Alzheimer's disease (AOR = 3.28; CI: 1.96-5.50), neuroleptic therapy (AOR = 1.87; CI: 1.22-2.88), co-morbidities hypertension (AOR = 2.03; CI: 1.41-2.90), and heart failure (AOR = 4.85; CI: 3.42-6.88). The chance for a prescription of any anti-dementia drug decreased with the diagnosis of vascular dementia (AOR = 0.64; CI: 0.43-0.95) and diabetes mellitus (AOR = 0.55; CI: 0.36-0.86). The prescription of <it>Ginkgo biloba </it>was associated with sex (female: AOR = 0.41; CI: 0.19-0.89), patient age (AOR = 1.06; CI: 1.02-1.10), treatment by a neurologist (AOR = 0.09; CI: 0.03-0.23), and the diagnosis of Alzheimer's disease (AOR = 0.07; CI: 0.04-0.16).</p> <p>Conclusions</p> <p>This study provides a comprehensive analysis of everyday practice for treatment of dementia in primary care in physicians with a focus on CAM. The prescribing frequency for anti-dementia drugs is equivalent to those found in other German studies, while the administration of <it>Ginkgo biloba </it>is significantly higher.</p

Deciding finiteness of petri nets up to bisimulation

Abstract We study the following problems for strong and weak bisimulation equivalence: given a labelled Petri net and a finite transition system, are they equivalent?; given a labelled Petri net, is it equivalent to some (unspecified) finite transition system? We show that both problems are decidable for strong bisimulation and undecidable for weak bisimulation. 1 Introduction The decidability of equivalence notions for infinite-state systems has been extensively studied in the last years. Among other results, it has been shown that trace equivalence is undecidable for Basic Process Algebra (BPA) and Basic Parallel Processes (BPP), while bisimulation equivalence is decidable in both cases [1, 2, 4]

Kostenorientierte Strompreisbildung: Entwicklung und Test eines lastabhaengigen Echtzeit-Tarifs in Eckernfoerde

Available from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, D-21400 Kiel C 208338 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Gruener Tarif: Klimaschutz durch freiwillige Kundenbeitraege zum Stromtarif: Akzeptanz, Umsetzung, Verwendung

Available from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, D-21400 Kiel C 206362 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Liberalisierung der Strommaerkte in Skandinavien und ihre Auswirkungen: Studie

SIGLEAvailable from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, D-21400 Kiel C 206054 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Kommunaler Klimaschutz: eine Bestandsaufnahme kommunaler Energiepolitik in Schleswig-Holstein

Available from Bibliothek des Instituts fuer Weltwirtschaft, ZBW, D-21400 Kiel C 206363 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman