Document Detail


Predictors of adherence among Alzheimer's disease patients receiving oral therapy.
MedLine Citation:
PMID:  20569067     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Treatment effectiveness depends upon administering medications as prescribed, and adherence is critical for Alzheimer's disease (AD) patients to receive optimal benefit from therapy. The objective of this study was to investigate factors associated with adherence to AD oral medications. METHODS: This retrospective claims analysis identified AD patients who initiated oral AD therapy (rivastigmine, donepezil, galantamine, or memantine) between January 1, 2006 and December 31, 2007 from a large US health plan. Patient baseline characteristics were assessed during the 6-month pre-index period; outcomes were assessed during the 1-year post-index period. Pill burden was measured as a count of unique units of medication/day. Adherence was measured by medication possession ratio (MPR), with MPR >or=80% defined as adherent. Multivariate logistic regression was used to assess how potential covariates affect adherence probability. RESULTS: A total of 3091 AD patients (36% male; mean age 80 [8.25 SD]) were identified. Only 58% of patients were adherent to oral AD medications. Compared to patients <75 years, patients >or=86 years were likely to be more adherent (OR = 1.401, p < 0.001). Other factors found to be positively associated with the probability of adherence to AD medications were male gender (OR = 1.175, p < 0.05), overall pill burden (OR = 1.192, p < 0.001), and a lower formulary tier status of the AD medication (OR = 1.332, p < 0.001). CONCLUSION: Among the several variables assessed, being male, >or=86 years of age, having a greater overall daily pill burden, or using a lower formulary tier AD medication was associated with better adherence to oral AD medication in patients diagnosed with AD. The database had no information on caregiver support, medication management interventions, or use of adherence aids that may have affected adherence in this cohort, yet, a substantial proportion of patients (42%) remained non-adherent. A better understanding of the causes of non-adherence is necessary, and methods to improve adherence, such as transdermal medications and educational programs, should be considered.
Authors:
Bijan Borah; Patricia Sacco; Victoria Zarotsky
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Current medical research and opinion     Volume:  26     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  1957-65     Citation Subset:  IM    
Affiliation:
i3 Innovus, Eden Prairie, MN, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Aged, 80 and over
Alzheimer Disease / drug therapy*
Dopamine Agents / administration & dosage
Female
Galantamine / administration & dosage
Humans
Indans / administration & dosage
Insurance Claim Review / statistics & numerical data
Logistic Models
Male
Medication Adherence / statistics & numerical data*
Memantine / administration & dosage
Neuroprotective Agents / administration & dosage*
Nootropic Agents / administration & dosage
Phenylcarbamates / administration & dosage*
Piperidines / administration & dosage
Predictive Value of Tests
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Dopamine Agents; 0/Indans; 0/Neuroprotective Agents; 0/Nootropic Agents; 0/Phenylcarbamates; 0/Piperidines; 120011-70-3/donepezil; 123441-03-2/rivastigmine; 19982-08-2/Memantine; 357-70-0/Galantamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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