Diagnostic and Prescription Behavior of General Practitioners and Specialist Physicians in Patients with Dementia in 2005 and 2015 in Germany

Research Question Did the diagnostic and treatment behavior of general practitioners and specialists in patients with dementia (PWD) change in Germany over a period of 11 years (2005 vs. 2015)? Methods We performed a retrospective, database-based evaluation of diagnostic and prescription data from more than 398 general practices (GP) and 50 specialist practices (SP). Results Compared to 2005, in 2015, the number of PWD had increased by 40.7% in GP and by 52.4% in SP. The proportion of patients with DAT (Alzheimer's Disease) had increased from 45.8% to 61.7% in SP. The latter changes are different from those in GP, where the proportion of patients with DAT had decreased from 20.8% to 19.2 %. On average, each individual GP treated 29.9 PWD in 2015 (2005: 21.3), of which 5.9 were DAT patients (2005: 4.4), and 1.7 DAT patients received an antidementia drug (2005: 1.3). On the other hand, an average of 115.4 PWD were diagnosed in SP in 2015 (2005: 75.7), 71.2 of which were DAT patients (2005: 34.7). 54.4 received an antidementia drug (2005: 23.9). Conclusions Improvements in the diagnosis of dementia and the prescription of antidementia drugs were only found in SP. In light of their comparatively low potential for change, whether GP will change their diagnostic and treatment behavior in the future and how SP can be better integrated into the process of outpatient dementia care remains to be seen.