ArticleCNS drugs2014
A 2-year prospective cohort study of antidementia drug non-persistency in mild-to-moderate Alzheimer's disease in Europe : predictors of discontinuation and switch in the ICTUS study.
Article in CNS drugs, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Persistence with anti-dementia medications: a systematic review and meta-analysis.Age and ageing · 2025Pooled it
- Effect of Psychoeducational Intervention on Donepezil Retention Rate and Analysis of Reasons for the Discontinuation in Patients with Alzheimer's Dementia: A Randomized Study.Patient preference and adherence · 2021Trial
- Regional disparities of antidementia drug treatment in Germany: what can we learn for the new generation of Alzheimer's therapies.Alzheimer's research & therapy · 2025Article
- Adherence of Anti-Dementia Medications in Alzheimer's Disease and Related Dementia: A Nationwide Cohort Study in Korea.Journal of Korean medical science · 2025Article
- Survival outcomes among hospitalized patients with dementia: a propensity score matching analysis.Acta neurologica Belgica · 2025Article
- Behavioural analysis of factors influencing prescribing for neurodegenerative diseases: A rapid review.PloS one · 2025Review
- Inequalities in the Quality and Safety of Post-Diagnostic Primary Care for People With Dementia: A Scoping Review.International journal of geriatric psychiatry · 2024Article
- Observational
- Non-adherence to antidementia medications and associated factors: a study of Spanish population-based registry data.Frontiers in pharmacology · 2024Article
- Analysis of treatment pattern of anti-dementia medications in newly diagnosed Alzheimer's dementia using OMOP CDM.Scientific reports · 2022Observational
- Anti-Dementia Drug Persistence Following Donepezil Initiation Among Alzheimer's Disease Patients in Japan: LIFE Study.Journal of Alzheimer's disease : JAD · 2022Article
- Pattern of treatment of behavioural and psychological symptoms of dementia and pain: evidence on pharmacoutilization from a large real-world sample and from a centre for cognitive disturbances and dementia.European journal of clinical pharmacology · 2021Observational
- Observational
- Risk for Health Events After Deprescribing Acetylcholinesterase Inhibitors in Nursing Home Residents With Severe Dementia.Journal of the American Geriatrics Society · 2020Article
- Impact of deprescribing AChEIs on aggressive behaviors and antipsychotic prescribing.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2020Article
- Factors Associated With Deprescribing Acetylcholinesterase Inhibitors in Older Nursing Home Residents With Severe Dementia.Journal of the American Geriatrics Society · 2019Article
- Article
- Tolerability of Cholinesterase Inhibitors: A Population-Based Study of Persistence, Adherence, and Switching.Drugs & aging · 2017Article
- Racial and Ethnic Differences in Initiation and Discontinuation of Antidementia Drugs by Medicare Beneficiaries.Journal of the American Geriatrics Society · 2016Article
- Persistence and adherence with dementia pharmacotherapy: relevance of patient, provider, and system factors.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2014Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is no consensus on when and how to discontinue cholinesterase inhibitors (ChEI). Predictors of non-persistency of antidementia drugs have been poorly investigated, mostly during short-term periods and using administrative data.
objectiveThe aim of this study was to investigate the incidence and predictors of ChEI switch and discontinuation among subjects with ascertained Alzheimer's disease (AD).
methodsA total of 557 community-dwelling, mild-to-moderate AD subjects initiating ChEIs in 29 European clinic centres were assessed twice-yearly for 2 years. Antidementia drug exposure was recorded through a physician-administered structured questionnaire to document any change in drug therapy (start and stop dates, reasons). Discontinuation was defined as >35 days without any antidementia drug. Switch was defined as a change for any antidementia drug strategy within 35 days after ChEI cessation. Two separate time-dependent multivariate Cox survival analyses were conducted to identify predictors of discontinuation and switch.
resultsThe incidences of discontinuation and switch were 9.65 and 12.47/100 person-years, respectively. Behavioural disturbances, low body mass index, falls, decline in Mini-Mental State Examination (MMSE) score, and AD-related hospitalization predicted discontinuation. MMSE score, decline in activities of daily living score, aberrant motor behaviour, shorter AD duration and higher nurse resource use predicted a switch. An ineffective ChEI dose and clinic specialty predicted both outcomes. Sensitivity analyses using a 60-day cut-off provided stable results.
conclusionSeveral predictors were identified: adverse drug events and their predisposing factors, perceived loss of efficacy or disease progression on cognitive or functional scales, behavioural disturbances, hospitalization and professional practices. The latter implies a need for harmonization in AD drug prescription practice.
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