Vulnerable Strata to Non-Adherence and Overuse in Treatment for Patients with Cognitive Impairment
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and purpose: Appropriate medication treatment could enable both cognitively impaired patients and caregivers to hold on their cognitive functioning and quality of life. Thus, medication management and the factors influencing how management for this condition is carried out must be identified. In this study we aimed to evaluate the frequency of medication nonadherence (MNA) or drug overuse for cognitive impairment (DOC) and to extract significant variables, including the demographic and social characteristics, vascular risk factors, and cognitive status, for the diagnosis of MNA and DOC in Korean patients. Methods: We investigated patients aged over 50 years between March 2019 and June 2019 via the cognitive enHancement of patIents with acQuired cognitive impairment (HIQ) campaign. MNA was defined as a participant who was classified as having cognitive impairment but did not take any cognition-related drugs, whereas DOC was defined as a participant who had normal cognition but was taking cognition-related drugs. Results: We included 10,767 patients. The MNA group consisted of 337 participants, whereas the DOC group comprised 1,107 participants. The factors that could differentiate the MNA group from the normal-behavior group were age, education, sex, and the total Korean version of Mini-Mental State Examination (K-MMSE) score. The factors that could differentiate the DOC group from the normal medication-behavior group were age, sex, residential distinction, experience of a dementia screening test, and the total K-MMSE score. Conclusions: The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.
Abstract
Background and purpose: Appropriate medication treatment could enable both cognitively impaired patients and caregivers to hold on their cognitive functioning and quality of life. Thus, medication management and the factors influencing how management for this condition is carried out must be identified. In this study we aimed to evaluate the frequency of medication nonadherence (MNA) or drug overuse for cognitive impairment (DOC) and to extract significant variables, including the demographic and social characteristics, vascular risk factors, and cognitive status, for the diagnosis of MNA and DOC in Korean patients. Methods: We investigated patients aged over 50 years between March 2019 and June 2019 via the cognitive enHancement of patIents with acQuired cognitive impairment (HIQ) campaign. MNA was defined as a participant who was classified as having cognitive impairment but did not take any cognition-related drugs, whereas DOC was defined as a participant who had normal cognition but was taking cognition-related drugs. Results: We included 10,767 patients. The MNA group consisted of 337 participants, whereas the DOC group comprised 1,107 participants. The factors that could differentiate the MNA group from the normal-behavior group were age, education, sex, and the total Korean version of Mini-Mental State Examination (K-MMSE) score. The factors that could differentiate the DOC group from the normal medication-behavior group were age, sex, residential distinction, experience of a dementia screening test, and the total K-MMSE score. Conclusions: The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.
참고문헌 (22)
- 최호진, "Survey of Current Status and Cognition of Activities of Daily Living in Dementia Patients: the 2018 “Il-sang-ye-chan” Campaign", Dementia and Neurocognitive Disorders(대한치매학회지), 18(1), pp.1~9 (2019), 대한치매학회[DOI]
- Schwartz SM, "The impact of an online disease management program on medical costs among health plan members", Am J Health Promot, 25, pp.126~133 (2010)
- Haider B, "Medication adherence in patients with dementia : an Austrian cohort study", Alzheimer Dis Assoc Disord, 28, pp.128~133 (2014)
- Smith D, "A systematic review of medication non-adherence in persons with dementia or cognitive impairment", PLoS One, 12, pp.e0170651~ (2017)
- Thiruchselvam T, "Risk factors for medication nonadherence in older adults with cognitive impairment who live alone", Int J Geriatr Psychiatry, 27, pp.1275~1282 (2012)
- Park J, "Marketing and pricing strategies of blockbuster drugs in the South Korean market : a 15-year retrospective cohort study for choline alfoscerate", Front Pharmacol, 11, pp.232~ (2020)
- 양영순, "A Multicenter, Randomized, Double-blind, Placebo-controlled Clinical Trial for Efficacy of Acetyl-L-carnitine in Patients with Dementia Associated with Cerebrovascular Disease", Dementia and Neurocognitive Disorders(대한치매학회지), 17(1), pp.1~10 (2018), 대한치매학회[DOI]
- Park JH, "Standardization of Korean of the Mini-Mental State Examination (MMSE-K) for use in the elderly. Part II. Diagnostic validity", J Korean Neuropsychiatr Assoc, 28, pp.508~513 (1989)
- Suh GH, "Validation of the severe impairment battery for patients with Alzheimer's disease in Korea", Int J Geriatr Psychiatry, 21, pp.626~632 (2006)
- Pfister B, "Drug-related problems and medication reviews among old people with dementia", BMC Pharmacol Toxicol, 18, pp.52~ (2017)
- Hajjar ER, "Unnecessary drug use in frail older people at hospital discharge", J Am Geriatr Soc, 53, pp.1518~1523 (2005)
- El-Saifi N, "Determinants of medication adherence in older people with dementia from the caregivers' perspective", Int Psychogeriatr, 31, pp.331~339 (2019)
- Okuno J, "Is cognitive impairment a risk factor for poor compliance among Japanese elderly in the community", Eur J Clin Pharmacol, 57, pp.589~594 (2001)
- Hennein R, "Barriers to medication adherence and links to cardiovascular disease risk factor control : the Framingham Heart Study", Intern Med J, 48, pp.414~421 (2018)
- Stoehr GP, "Factors associated with adherence to medication regimens in older primary care patients : the Steel Valley Seniors Survey", Am J Geriatr Pharmacother, 6, pp.255~263 (2008)
- Mackin RS, "Cognitive and psychiatric predictors of medical treatment adherence among older adults in primary care clinics", Int J Geriatr Psychiatry, 22, pp.55~60 (2007)
- El-Saifi N, "Medication adherence in older patients with dementia : a systematic literature review", J Pharm Pract, 31, pp.322~334 (2018)
- Lai HY, "Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program", Clin Ther, 31, pp.1859~1870 (2009)
- Raina P, "Effectiveness of cholinesterase inhibitors and memantine for treating dementia : evidence review for a clinical practice guideline", Ann Intern Med, 148, pp.379~397 (2008)
- Aston L, "Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community : a mixed studies review", BMC Geriatr, 17, pp.242~ (2017)
- O'Mahony D, "Inappropriate prescribing in the older population : need for new criteria", Age Ageing, 37, pp.138~141 (2008)
- Lim RH, "Medicines management issues in dementia and coping strategies used by people living with dementia and family carers : a systematic review", Int J Geriatr Psychiatry, 33, pp.1562~1581 (2018)