Comparison of Cholinesterase Inhibitor Utilization Patterns and Associated Health Care Costs in Alzheimer's Disease

Mucha, Lisa; Shaohung, S; Cuffel, Brian J.; McRae, Thomas; Tl, Mark; Valle, Manel del

doi:10.18553/jmcp.2008.14.5.451

Cited by 55 publications

(61 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Quanto aos IChE solicitados, houve uma inversão do padrão brasileiro em 2008, descrito por Cintra et al 27 , no qual a rivastigmina foi o medicamento mais prescrito, possivelmente por ter sido o primeiro IChE a ser disponibilizado gratuitamente no Brasil. O padrão observado no presente trabalho, entretanto, é semelhante ao observado nos Estados Unidos, Canadá e Austrália 28,29,30 . O PCDT não faz distinção de qual medicamento deve ser utilizado como primeira escolha, e o resultado pode refletir os diferentes perfis de intolerância ou contraindicações a um ou outro medicamento, bem como a preferência do prescritor 6 .…”

Section: Discussionunclassified

Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

et al. 2016

View full text Add to dashboard Cite

Resumo: Avaliou-se as barreiras de acesso ao tratamento da doença de Alzheimer com base nos processos administrativos de medicamentos inibidores da colinesterase (IChE), enviados à Secretaria de Estado de Saúde de Minas Gerais, Brasil, entre 2012 e 2013. Utilizando-se informações de 165 processos selecionados aleatoriamente, abordaram-se as dimensões de acesso: acessibilidade geográfica, acomodação, aceitabilidade, disponibilidade e capacidade aquisitiva. O trâmite administrativo para o fornecimento dos IChE levou em média 39 dias e foi influenciado por características do trajeto percorrido pelo usuário. A maioria dos prescritores cumpriu menos de 80% dos critérios exigidos pelo Protocolo Clínico e Diretrizes Terapêuticas (PCDT) da doença de Alzheimer. Como resultado, 38% dos processos não foram deferidos. A capacidade aquisitiva para o tratamento privado mensal com IChE foi de cerca de 21 dias de salário mínimo. Conclui-se que a burocracia do trâmite administrativo e a dificuldade de seguimento do PCDT pelos prescritores prejudicam o acesso ao tratamento da doença de Alzheimer e constituem uma grande carga para o orçamento dos pacientes.

show abstract

Section: Discussionunclassified

Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Our results are in line with previously published studies of persistence rates for ChEIs, which are between 32% and 47% within the first year in real-life settings. 12,21 Randomized controlled trials with a follow-up of 6 months reported higher persistence rates ranging from 59% to 64%. 14,22 One study showed modest, yet significant differences in adherence to donepezil, rivastigmine, and galantamine.…”

Section: Discussionmentioning

confidence: 99%

Medication Adherence in Patients With Dementia

Haider¹,

Schmidt

Schweiger

et al. 2014

Alzheimer Disease &Amp; Associated Disorders

View full text Add to dashboard Cite

Sustained treatment with effective doses of cholinesterase inhibitors or memantine is crucial to transfer treatment effects in dementia. Numerous studies, with often small samples sizes, describe low adherence rates. The purpose of current study was to examine the medical adherence of antidementia therapy in Austria. We analyzed the data of 10 Austrian Health Insurance Funds, including treatment-naive dementia patients. Study outcome measures were discontinuation, switching, number of days on therapy, Medication-Possession-Ratio, and compliance. A total of 15,809 patients (mean age: 79.9 y, female: 67.3%) met the study's inclusion criteria. After stratification by index medication there were 40.3% on donepezil (n=6371); 26.6% on rivastigmine (n=4206); 15.3% on galantamine (n=2424); and 17.8% on memantine (n=2808). After 6 and 12 months on therapy, 5376 (34.0%) and 9243 (58.5%) patients stopped the initially prescribed antidementia therapy; after 12 months the highest discontinuation rate was seen for patients taking rivastigmine (67.3%), whereas patients on memantine (45.0%) had the lowest. After 12 months, a total of 1874 (11.9%) patients switched from their index medication to another cholinesterase inhibitor or memantine. A total of 6163 patients (39.0%) were compliant (Medication-Possession-Ratio >80%) during the first 6 months and 5366 patients (33.9%) during 12 months of the study. Our study shows that memantine-treated patients adhere significantly better to treatment. Specifically, after 12 months, 45.0% discontinued medication, 7.9% switched, and 50.8% of patients on therapy were compliant.

show abstract

“…30, 60 or 90 days between prescription refills) or the environmental settings in which adherence has been studied (table 1). Many studies investigating treatment adherence or persistence in patients with AD have been performed using retrospective analyses of administrative health databases or pharmacy claims [21,22,23,24,25,26,27,28,29,30,31,32]. It should be noted that in all of these studies, evaluation of adherence is based on drug dispensation and not actual drug intake by the patient.…”

Section: Treatment Adherence In Admentioning

confidence: 99%

Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

Brady

Weinman

2013

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background/Aims: Treatment adherence is a major problem in numerous medical conditions, and is a particular challenge in patients with Alzheimer's disease (AD). Methods: This non-systematic review summarises the current literature on factors that affect adherence to cholinesterase inhibitors, the mainstay of AD treatment. Articles listed on PubMed and published during the last 10 years were included. Results: Intentional factors affecting adherence include patient, caregiver and prescriber beliefs about therapies and the disease itself. Unintentional factors include tolerability, physical limitations of the patient and caregiver burden. Interventions aiming to improve adherence include educational programmes and new drug delivery methods. Conclusion: Due to the high level of caregiver involvement in the care of patients with AD, strategies that address caregiver concerns may improve adherence.

show abstract

Comparison of Cholinesterase Inhibitor Utilization Patterns and Associated Health Care Costs in Alzheimer's Disease

Cited by 55 publications

References 12 publications

Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

Medication Adherence in Patients With Dementia

Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

Contact Info

Product

Resources

About