Factors associated with persistence of cholinesterase inhibitor treatments in the elderly

Pariente, Alexandre; Pinet, Marion; Moride, Yola; Merlière, Yvon; Moore, Nicholas; Fourrier‐Réglat, Annie

doi:10.1002/pds.1933

Cited by 28 publications

(27 citation statements)

References 35 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While many studies reported no statistically significant association between ChEI persistence and age or sex, several reports suggest that older patients (for example, aged 75 and older) 34,38,39,45,46,50,53 and female patients 34,43,44 may be more likely to discontinue ChEI therapy. An association with advanced age may reflect the impact of more advanced disease severity, 31 a perceived lack of therapeutic benefit, or concerns about a heightened risk for adverse effects.…”

Section: Patient-level Factorsmentioning

confidence: 99%

“…47,55,59 Conversely, persistence appears to be higher with concurrent use of various antidepressants, a number of which can have anticholinergic effects. 43,45 Previous cross-sectional research suggests a higher likelihood for ChEI use among patients concurrently exposed to antidepressants and antipsychotics. 69,72 Possibly, all 3 classes are being prescribed to treat patients with AD with more severe mood or behavioural difficulties.…”

Section: Patient-level Factorsmentioning

confidence: 99%

“…93 However, another French study found no association between ChEI persistence and the specialty of the initial prescriber. 45 Variation in ChEI adherence related to differential access to care (including the availability of physicians, specialists, pharmacists, and other support services) across geographic regions has been suggested by US research 62 but remains relatively unexplored in the Canadian context. The one Canadian study that examined potential urban and rural differences 44 reported a higher discontinuation rate among patients with AD residing in an urban setting, but this association did not remain significant in adjusted analyses.…”

Section: Health System and Provider Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

et al. 2014

View full text Add to dashboard Cite

This paper provides a comprehensive review of studies examining adherence and (or) persistence with dementia pharmacotherapy during the past decade, including a summary of the key patient-, drug-, system-, and provider-level factors associated with these measures. Estimates of adherence and 1-year persistence to these drugs have ranged from 34% to 94% and 35% to 60%, respectively. Though many studies reported nonsignificant associations, there are data suggesting that patient age, sex, ethnoracial background, socioeconomic status, and region-specific reimbursement criteria, as well as the extent and quality of interactions among patients, caregivers, and providers, may influence persistence with pharmacotherapy. As many studies relied on administrative data, limited information was available regarding the relevance of patient's cognitive and functional status or the importance of caregiver involvement or assistive devices to adherence or persistence. W W WPersistance et observance de la pharmacothérapie de la démence : pertinence des facteurs liés au patient, au fournisseur, et au système Cet article offre une revue détaillée des études examinant l'observance et (ou) la persistance de la pharmacothérapie de la démence au cours des dix dernières années, dont un résumé des principaux facteurs au niveau du patient, du médicament, du système et du fournisseur qui sont associés à ces mesures. Les estimations de l'observance et de la persistance d'un an à ces médicaments allaient de 34 % à 94 % et de 35 % à 60 %, respectivement. Même si de nombreuses études faisaient état d'associations non significatives, des données suggèrent que l'âge, le sexe, les origines ethnoraciales, le statut économique des patients et leurs critères de remboursement régionaux, ainsi que l'étendue et la qualité des interactions entre patients, soignants, et fournisseurs peuvent influencer la persistance de la pharmacothérapie. Comme bon nombre d'études s'appuyaient sur des données administratives, l'information disponible était limitée en ce qui concerne la pertinence de l'état cognitif et fonctionnel du patient, ou l'importance de l'implication du soignant ou des dispositifs d'assistance à l'observance ou à la persistance. In 2008, the estimated number of people with dementia in Canada was nearly half a million.2 Ensuring appropriate pharmacotherapy is an important component of care for people with dementia.3,4 ChEIs (for example, donepezil, rivastigmine, and galantamine) and the N-methyl-daspartate receptor antagonist memantine are approved for the symptomatic treatment of AD. 3,4 Recommendations made at the fourth CCCDTD (in 2012) included offering all people with AD a trial of a ChEI unless there are contraindications, using these agents for Parkinson disease dementia, and considering memantine for AD at a moderateto-severe stage. 5Investigating adherence and persistence with dementia pharmacotherapy is important in understanding both the therapeutic benefits and the cost-effectiveness of these medications. As symptomatic therapies, trea...

show abstract

Section: Patient-level Factorsmentioning

confidence: 99%

Section: Patient-level Factorsmentioning

confidence: 99%

Section: Health System and Provider Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

et al. 2014

View full text Add to dashboard Cite

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%

“…Additionally, in a French study, 1-year persistence of ChEI treatment was estimated at 45.3% of 942 patients. The authors concluded that to optimise persistence with ChEIs, patients presenting with more severe symptoms and/or those aged over 80 years should be especially monitored [29]. …”

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

Current awareness in geriatric psychiatry

2010

Int J Geriat Psychiatry

View full text Add to dashboard Cite

In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Reviews; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

show abstract

Factors associated with persistence of cholinesterase inhibitor treatments in the elderly

Abstract: One-year persistence of ChI treatment was estimated at 45.3% in this French sample. To optimize persistence of ChI treatment in the demented, patients poorly symptomatic and/or aged over 80 years should be especially monitored.

Cited by 28 publications

References 35 publications

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

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

Current awareness in geriatric psychiatry

Contact Info

Product

Resources

About