Prescribing patterns for Alzheimer disease: survey of Canadian family physicians

Objective — To describe Canadian family physicians' prescribing practices with regard to Alzheimer disease (AD).

Design — Cross-sectional survey administered by facsimile.

Setting — Four regions in Canada (British Columbia, the Prairie Provinces, Ontario, and the Atlantic Provinces).

Participants — A stratified random sample of 1000 Canadian family physicians (250 per region) chosen from the Canadian Medical Directory; 81 of whom were excluded as ineligible.

Main Outcome Measures — Prescribing practices regarding cholinesterase inhibitors (ChIs) for patients with AD.

Results — Response rate was 36.3%. About 27% of respondents reported that ChIs were prescribed for less than 10% of their AD patients, while 12.5% reported that ChIs were prescribed for more than 90% of their AD patients. More physicians prescribed ChIs in the two regions with provincial formulary coverage (Prairie Provinces and Ontario) than in the two regions without coverage (British Columbia and Atlantic Provinces). Factors that significantly predicted lower prescribing rates included female sex, perception of ChIs' effectiveness, and self-reported knowledge of ChIs.

Conclusion — Canadian physicians' prescribing patterns for ChIs vary; the optimal prescribing rate is unclear. Provincial coverage of these drugs along with physicians' sex, knowledge of ChIs, and perception of the effectiveness of ChIs appear to influence prescribing rates.