Work

Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program

Year: 2008

Type: article

Abstract: OBJECTIVE: To compare levels of persistency between cholinesterase inhibitors (ChEIs) among a Medicaid patient population of older adults. METHODS: Survival analysis was used to assess differences in discontinuation between ChEIs (donepezil versus rivastigmine and galantamine), and for difference in patient gender, age, race, and care setting. RESULTS: Rates of discontinuation increased from 42.7% (95% CI = 39.9-45.5) at 12 months to 84.8% (95% CI = 82.3-87.3) at 24 months. In multivariate models, no significant difference in discontinuation existed prior to 365 days. However, patients dispensed donepezil were less likely to discontinue as compared with users of the other two ChEIs after the first year (RR = 0.70; CI = 0.499-0.983; p < 0.04). Patients of white race were less likely to discontinue (RR = 0.549; 95% CI = 0.43-0.82; p = 0.0015), while gender, care setting, and age were not associated with discontinuation. CONCLUSIONS: One-year persistence rates were similar between different ChEIs. Among patients persisting with ChEI medication for at least 12 months, users of donepezil were slightly more likely to continue to persist at 24 months. Nearly half of patients failed to persist with ChEI therapy for at least 12 months. Our findings underscore the limitations of the ChEI medications and the urgent need for effective and tolerable therapeutic options for patients having dementia.

Source: Patient Preference and Adherence

DOI: 10.2147/ppa.s2652

Author: Susan Abughosh

Institution: Massachusetts College of Pharmacy and Health Sciences

Language: English

Topic: Medication Adherence and Compliance

Subfield: Family Practice

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836