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Anti-dementia medication use in Aotearoa New Zealand

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Authors:
Summary:

Māori, alongside other non-Europeans, are less likely to receive funded anti-dementia medication than individuals of European ethnicity, according to a retrospective study using health data from the Integrated Data Infrastructure. The study identified individuals of all ages coded with dementia, and found that one-third received donepezil or rivastigmine between 1 July 2016 and 30 June 2020. The relative risks for Māori, Pasifika, and Middle Eastern/Latin American/African individuals being dispensed an anti-dementia medication compared with European individuals were 0.79-0.81 (p < 0.0001), 0.72-0.74 (p < 0.0001) and 0.73-0.78 (p < 0.05), respectively. Individuals aged 65-79 years were more likely and those aged <65 years were less likely to be dispensed an anti-dementia medication compared with those aged ≥80 years (relative risks 1.50-1.54 and 0.67-0.71, respectively; both p < 0.0001). Anti-dementia medication use was not significantly different between males and females.

Comment:
Demonstrating the ‘inverse care law’, with one study presenting up-to-date information demonstrating the higher prevalence of cognitive impairment for Māori, and the second paper highlighting that they are 20% less likely to receive anti-dementia medication.
Reference: Aust N Z J Psychiatry. 2023;57(6):895-903.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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