Article type
Abstract
"Background: Globally, 50 million people suffer from dementia. The primary cause of dementia is Alzheimer's disease (AD), which accounts for up to 70% of cases worldwide and about 60% of cases in Brazil. The most recent version of Brazilian Unified Health System (SUS) AD guidelines dates from 2017.
Objectives: Describe the main healthcare recommendations and the updating process of the SUS AD clinical practice guideline (CPG) for patients with suspected or confirmed AD.
Methods: Researchers, experts (such as psychiatrists, neurologists, and psychologists), Brazilian Ministry of Health (MoH) delegates, and patients participated in the GRADE-based process of updating guidelines. After three meetings, participants outlined the document and the priority of technology assessments for potential coverage in SUS.
Results: New recommendations addressed pharmacological and non-pharmacological methods such as cognitive stimulation treatment (CST), psychoeducational therapies, caregiver support, and palliative care. Highlights include the evaluation of donepezil in severe AD (currently available for mild to moderate AD) and the adoption of memantine in both solution and orodispersible tablets (currently available as tablets). In the SUS perspective, donepezil and CST were cost-effective, while alternative forms of memantine might have a five-year budgetary impact of R$ 143 million (US$ 29 million). This CPG will be evaluated by Conitec (National Committee for Health Technology Incorporation). Conitec will consider the technology evaluations and public consultation before making the decision to update guidelines.
Conclusions: The updated guideline is expected to improve the care of individuals with AD, enhancing primary and secondary healthcare standards while promoting the universality, comprehensiveness, and equity ideals of SUS. "
Objectives: Describe the main healthcare recommendations and the updating process of the SUS AD clinical practice guideline (CPG) for patients with suspected or confirmed AD.
Methods: Researchers, experts (such as psychiatrists, neurologists, and psychologists), Brazilian Ministry of Health (MoH) delegates, and patients participated in the GRADE-based process of updating guidelines. After three meetings, participants outlined the document and the priority of technology assessments for potential coverage in SUS.
Results: New recommendations addressed pharmacological and non-pharmacological methods such as cognitive stimulation treatment (CST), psychoeducational therapies, caregiver support, and palliative care. Highlights include the evaluation of donepezil in severe AD (currently available for mild to moderate AD) and the adoption of memantine in both solution and orodispersible tablets (currently available as tablets). In the SUS perspective, donepezil and CST were cost-effective, while alternative forms of memantine might have a five-year budgetary impact of R$ 143 million (US$ 29 million). This CPG will be evaluated by Conitec (National Committee for Health Technology Incorporation). Conitec will consider the technology evaluations and public consultation before making the decision to update guidelines.
Conclusions: The updated guideline is expected to improve the care of individuals with AD, enhancing primary and secondary healthcare standards while promoting the universality, comprehensiveness, and equity ideals of SUS. "