Female Physicians More Careful and Conservative when Prescribing Dementia Medication: Study
October 23, 2018 | Download Release
TORONTO, OCTOBER 23, 2018 – Female physicians treating older adults with dementia are more cautious and conservative when prescribing cholinesterase inhibitors (ChEIs) medications than male physicians, according to a new study by researchers at Women's College Hospital (WCH) and ICES.
ChEIs, a widely prescribed medication, are one of the only drug therapies approved for the management of dementia. ChEIs provide modest benefit for patient cognitive function. As such, there is little need for patients to quickly reach maximum-therapeutic dosage.
Using administrative health data housed at ICES, researchers examined physician prescribing and care practices provided to 73,111 community-dwelling older adults in Ontario aged 66 and older with dementia who were newly dispensed an oral ChEIs (donepezil, galantamine, rivastigmine) between 2010 and 2016. The analysis included 3,443 female physicians and 5,811 male physicians.
The study published today in PLOS ONE, shows that female physicians are more likely than male physicians to initiate ChEIs at a lower than recommended dose (6.1 per cent vs. 4.1 per cent). Initiating a drug therapy, like ChEIs, at a low-dose is a measure of a more careful and conservative prescribing practice as negative side effects are often dose-related.
“This study is among the first to analyze the prescribing practices of male and female physicians. Our findings were consistent across specialties and location of practice,” says Dr. Paula Rochon, senior author on the study, vice-president of research at WCH and a senior core scientist at ICES.
The investigation also found that female physicians were more likely to have patients who had a cardiac screening prior to initiating a ChEI (55.1 per cent vs. 49.2 per cent). Additionally, female physicians were more likely to prescribe a shorter duration (30 days or less) of initial ChEI prescription versus their male counterparts (41.8 per cent versus 35.5 per cent).
“The evidence demonstrating that female physicians were more likely to initiate a lower medication dose, conduct cardiac screening for vulnerable patients and provide an initial prescription for a shorter duration suggests that they are more careful about preventing negative drug side effects. These findings add increasing evidence that there are notable differences in care provided to patients by male and female physicians. Going forward, we can use this information to learn how to improve prescribing practices for all,” adds Rochon.
Study findings suggests that further research should be conducted exploring this prescribing pattern for other widely used drug therapies, where a careful approach is justified. “Comparison of Prescribing Practices for Older Adults Treated by Female versus Male Physicians: A Retrospective Cohort Study” was published today in PLOS ONE.
Women’s College Hospital
For more than 100 years Women’s College Hospital (WCH) has been developing revolutionary advances in healthcare. Today, WCH is a world leader in the health of women and Canada’s leading, academic ambulatory hospital. A champion of health equity, WCH advocates for the health of all women from diverse cultures and backgrounds and ensures their needs are reflected in the care they receive. It focuses on delivering innovative solutions that address Canada’s most pressing issues related to population health, patient experience and system costs. The WCH Institute for Health System Solutions and Virtual Care (WIHV) is developing new, scalable models of care that deliver improved outcomes for patients and sustainable solutions for the health system as a whole.
Women’s College Research Institute (WCRI) is tackling some of the greatest health challenges of our time. Its scientists are conducting global research that advances the health of women and improves healthcare options for all, and are then translating those discoveries to provide much-needed improvements in healthcare worldwide.