[Prescription differences of dementia drugs in urban and rural areas in Germany].

OBJECTIVE: The objective of this study was to detect regional variability in anti-dementia drug prescriptions in metropolitan and rural regions of Germany in order to assess the widespread assumption that dementia treatment coverage is lower in rural areas because of the lower physician density in ambulatory care, especially for neuropsychiatrists.
METHODS: We compared the 2007 prescription rates for Donepezil, Rivastigmine, Galantamine and Memantine in defined daily doses per capita in the population aged 65 and older insured in the German Statutory Health Insurance. The prescription data for the States of Berlin and Hamburg were compared with those in the adjacent rural-type States of Brandenburg and Lower Saxony.
RESULTS: We found a greater proportion of both general practitioners and neuropsychiatrists prescribing dementia drugs and a higher population coverage with dementia drugs in the rural states compared to the urban states.
CONCLUSIONS: The data suggest that the drug coverage in case of dementia is better in rural than in urban states in spite of a lower physician density. This unexpected result can be explained by the fact that a smaller proportion of physicians participate in the prescription of dementia drugs in urban areas, a phenomenon probably related to differences in task description and clientele selection between physicians in urban and rural areas. © Georg Thieme Verlag KG Stuttgart · New York.