Qi Ju Di Huang Wan
is the Top Choice for Dementia
Patients in Taiwan
Few studies have reported on the utilization of traditional
Chinese medicine (TCM) among dementia patients. The aim of the present study is
to analyze factors associated with TCM users in the dementia populations and to
investigate the medical conditions related to TCM visits. A total of 18,141
dementia patients were screened from the one million sample of the National
Health Insurance Research Database. The dementia patients were then divided
into TCM users and non-TCM users according to their medical records between
1997 and 2008. Demographic characteristics included gender, age, insured
amount, and geographic location and medical conditions including comorbidity
diseases, behavioral and psychological symptoms, and anti-dementia medication
were also investigated. Their tendency of TCM usage was investigated using a
multivariate logistic regression. In Taiwan, 43.3% dementia patients had sought
TCM treatments. The inclination of TCM usage was inversely proportional to age;
the younger and early-onset dementia (age less than 55 years) patients
constituted the high usage group. Female, living in central Taiwan, and higher
insured amount were also associated with higher tendency of TCM use. Multilevel
Poisson regression analysis showed that the odds ratios (OR) of TCM use were
1.80 (95% CI=1.68-1.94), 2.52 (95% CI=2.30-2.76), 3.41 (95% CI=3.01-3.86) for
those with one, two, three or more behavioral and psychological symptoms of
dementia (BPSD), respectively compared with dementia sufferers without BPSD. In
additional, polypharmacy led to higher utilization of TCM (one type: Adjust
OR=1.41, 95% CI=1.28-1.56, two types: Adjust OR=1.97, 95% CI=1.63-2.00; three
or more types: Adjust OR =2.95, 95% CI=2.27-2.78). More than 70% TCM visits
were treated with Chinese herbal remedies, while others use acupuncture and
manipulative therapies. Qi-Ju-Di-Huang-Wan (9.7%) was the most frequently
prescribed formula, followed by Jia-Wei-Xiao-Yao-San and
Ban-Xia-Bai-Zhu-Tian-Ma-Tang. More than 40% of the dementia patients in Taiwan
used TCM. Young-onset dementia, higher number of BPSD, multiple chronic
diseases, and polypharmacy were independent predictors for dementia patients
seeking TCM medical advice. On the basis of the current findings, additional
clinical or epidemiologic study on the prescription patterns of TCM in dementia
treatment, or the herb-drug interaction and safety issue can be conducted.
Source: Lin S,
Tsai Y,
Lai J,
Wu C.
Demographic and
medication characteristics of traditional Chinese medicine users among dementia
patients in Taiwan: A nationwide database study. J Ethnopharmacol. 2014 Dec 16.
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