Medication Adherence in Patients With Dementia

Haider, Bernhard; Schmidt, Reinhold; Schweiger, Christine; Forstner, Thomas; Labek, Anna; Lampl, Christian

doi:10.1097/wad.0000000000000006

Cited by 29 publications

(38 citation statements)

References 23 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…89 Selection of which agent to be used will be based on adverse effect profile, ease of use, familiarity, and differences between the agents in their pharmacokinetics and other mechanisms of action. 5 There was an increased risk for early discontinuation 36,43 (and switching) 36,47 with subtherapeutic dosages of the ChEIs, as well as evidence of increased persistence in patients with AD using memantine (with 38 or without 35 a ChEI). The latter finding may be explained by greater caregiver involvement in drug administration coupled with a decision to aggressively pursue therapy.…”

Section: Drug-related Factorsmentioning

confidence: 99%

“…61 Comparisons across studies are challenging, given potentially incongruent methodology and differences in the measures and time periods employed. 35,40,52,[61][62][63][64] Adherence estimates may vary, both between and within patients with AD, illustrating the importance of capturing the dynamic nature of adherence behaviour. 66 Among patients with AD, the 1-year discontinuation rate for ChEIs ranges between 40% and 65%, with up to 90% stopping after 2 to 3 years.…”

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

“…We identified 27 English-language observational studies on persistence and 7 reporting measures of adherence with dementia pharmacotherapy. 35,40,52,[61][62][63][64] Several studies further considered the likelihood and related predictors of switching between medications and formulations. 35,36,39,47,64,65 Estimates of adherence range from 34% 35 to 94%.…”

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

“…35,40,52,[61][62][63][64] Several studies further considered the likelihood and related predictors of switching between medications and formulations. 35,36,39,47,64,65 Estimates of adherence range from 34% 35 to 94%. 61 The relatively high adherence in the report of Blais et al 61 likely reflects the degree of support provided to their participants (for example, use of weekly pill boxes with home delivery and caregiver assistance with medications).…”

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

See 3 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: Drug-related Factorsmentioning

confidence: 99%

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

Section: Overview Of Studies Examining Persistence and Adherencementioning

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

show abstract

“…This level of nonadherence is consistent with previous studies wherein rates of medication nonadherence for community-dwelling older adults with dementia are typically reported to exceed 30%. 23,24 As such, this study adds to the growing body of evidence that nurses and other homecare providers are highly likely to encounter caregiving dyads (patients + family members) who are experiencing problems with medication adherence. In clinical practice, it has traditionally been assumed that transferring medication management responsibilities over to a family caregiver will resolve such problems, yet baseline data from this study suggest that problematic medication management practices seem to persist despite the involvement of a family caregiver in medication management.…”

Section: Discussionmentioning

confidence: 87%

An intervention to maximize medication management by caregivers of persons with memory loss: Intervention overview and two-month outcomes

et al. 2016

View full text Add to dashboard Cite

Overseeing medication-taking is a critical aspect of dementia caregiving. This randomized controlled trial examined the efficacy of a tailored, problem-solving intervention designed to maximize medication management practices among caregivers of persons with memory loss. Eighty-three community-dwelling dyads (patient + informal caregiver) with a baseline average of 3 medication deficiencies participated. Home- and telephone-based sessions were delivered by nurse or social worker interventionists and addressed basic aspects of managing medications, plus tailored problem solving for specific challenges. The outcome of medication management practices was assessed using the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and an investigator-developed Medication Deficiency Checklist (MDC). Linear mixed modeling showed both the intervention and usual care groups had decreases in medication management problems as measured by the MedMaIDE (F=6.91, p<.01) and MDC (F=9.72, p<.01) at 2 months post-intervention. The phenomenon of reduced medication deficiencies in both groups suggests that when nurses or social workers merely raise awareness of the importance of medication adherence, there may be benefit.

show abstract

A 2-Year Prospective Cohort Study of Antidementia Drug Non-Persistency in Mild-to-Moderate Alzheimer's Disease in Europe

et al. 2014

View full text Add to dashboard Cite

show abstract

Medication Adherence in Patients With Dementia

Cited by 29 publications

References 23 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

An intervention to maximize medication management by caregivers of persons with memory loss: Intervention overview and two-month outcomes

A 2-Year Prospective Cohort Study of Antidementia Drug Non-Persistency in Mild-to-Moderate Alzheimer's Disease in Europe

Contact Info

Product

Resources

About