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• W2896599638 abstract "Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide. Current pharmacological treatment provides only symptomatic benefits. Clinicians are tasked with how to best assess patients and make treatment intervention decisions. We sought to identify patterns of decision-making in treatment initiation, selection, and modification, as well as decision drivers and expectations. Outreach to 96 healthcare professionals (50 Neurologists, 45 Geriatricians and 1 Psychiatrist), was made by 23 Lundbeck US Medical Science Liaisons between June 2016 and November 2016 to inquire about AD treatment related to: disease state; treatment initiation; treatment modification; assessment of patients and treatment effect; new treatment options. Most physicians (80%) think classification of AD patients according to symptoms/stage is important for making decisions on disease management. Neurologists and Geriatricians approach AD treatment based on the trigger of symptoms (59%); however, Neurologists are more likely to utilize the Mini-Mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MOCA) together with clinical judgement to define disease stage versus Geriatricians who are more likely to use clinical judgment and/or other scales (figure 1). Most initiate therapy at diagnosis even if symptoms are subtle (86%). Changes in therapy are driven by sub-optimal treatment response and 51% would consider combination therapy early to obtain additional benefit. Neurologists (34%) are more likely than Geriatricians (25%) to utilize higher doses than recommended in product package inserts. For new treatments, cognition, behavior, activities/functionality and disease progression are outcomes of most interest. Both groups think disease modifying treatments (DMT) and new symptomatic treatments (ST) are needed, however, Neurologists (57%) appear to value availability of new ST more than Geriatricians (27%). When DMT is available, 40% of physicians expect to use both ST and DMT in combination, while 27% expect to treat with DMT first and use ST later. More Geriatricians (21%) vs Neurologists (7%) would consider using ST only after the effect of DMT is absent. Geriatricians and Neurologists approach AD treatment initiation and changes in therapy similarly; they differ in patient assessment, willingness to use higher doses, perceived value for new symptomatic treatments, and use of symptomatic treatments in presence of disease modifying treatments." @default.
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• W2896599638 date "2018-07-01" @default.
• W2896599638 modified "2023-10-16" @default.
• W2896599638 title "P4‐140: CURRENT CLINICAL UNDERSTANDING OF THE TREATMENT OF ALZHEIMER'S DISEASE: PHYSICIANS’ PERSPECTIVES" @default.
• W2896599638 doi "https://doi.org/10.1016/j.jalz.2018.06.2544" @default.
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