{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:58:38Z","timestamp":1785772718980,"version":"3.56.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Population-based registries for Alzheimer\u2019s disease pharmacological treatment are essential tools for monitoring clinical guideline adherence and health system sustainability. This retrospective observational study analyzes 12\u00a0years of real-world data from the Catalan Registry of Pharmacological Treatment of Alzheimer\u2019s Disease (RTFMA) between 2012 and 2024. Analyzing a cohort of over 158,000 patients treated with acetylcholinesterase inhibitors or memantine, we found that the treated population increased by 24.5%, reaching 56,874 individuals in 2024. The implementation of a mandatory registration system was associated with high clinical appropriateness, with 81.9% of treatments initiated at recommended moderate stages (GDS 4\u20135), while only 8.6% began at mild stages. Despite the aging population and the impact of the COVID-19 pandemic\u2014which caused a transient decline in treatment initiations in 2020\u2014the system demonstrated resilience with a full recovery by 2023. Treatment discontinuation was primarily driven by mortality (95% of known reasons), indicating high persistence until end-of-life. From an economic perspective, Alzheimer\u2019s therapies represented a stable 1.9% of the total public pharmaceutical budget in 2023, reflecting effective cost containment through generic drug use. These findings suggest that a centralized, guideline-linked registry optimizes patient selection and maintains the economic viability of Alzheimer\u2019s care, providing a robust framework for the future integration of high-cost disease-modifying therapies.<\/jats:p>","DOI":"10.3389\/fphar.2026.1848809","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:52:22Z","timestamp":1784699542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A regional registry ensures clinical guideline adherence and economic sustainability of Alzheimer\u2019s disease treatment: a 12-year population-based study in Catalonia"],"prefix":"10.3389","volume":"17","author":[{"given":"Miriam","family":"Umbria","sequence":"first","affiliation":[{"name":"Rational Medicine Use Division, Medicine Area, Catalan Health Service","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Exposito","sequence":"additional","affiliation":[{"name":"Rational Medicine Use Division, Medicine Area, Catalan Health Service","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Gasol","sequence":"additional","affiliation":[{"name":"Rational Medicine Use Division, Medicine Area, Catalan Health Service","place":["Barcelona, Spain"]},{"name":"Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vallano","sequence":"additional","affiliation":[{"name":"Rational Medicine Use Division, Medicine Area, Catalan Health Service","place":["Barcelona, Spain"]},{"name":"Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","article-title":"Pautes per a l\u2019harmonitzaci\u00f3 del tractament farmacol\u00f2gic de la malaltia d\u2019Alzheimer","year":"2016","journal-title":"Dep. 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