Evidence map›Paper›PMID 28295141›Full record

Trial reportJournal of the American Geriatrics Society2017

Adherence and Tolerability of Alzheimer's Disease Medications: A Pragmatic Randomized Trial.

Noll L Campbell, Anthony J Perkins, Sujuan Gao, Todd C Skaar, Lang Li, Hugh C Hendrie, Nicole Fowler, Christopher M Callahan, Malaz A Boustani

Registry-linked trialAbstract readPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01362686 (Comparative Effectiveness Research Trial of Alzheimer's Disease Drugs), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01362686 naterminatednot on this map

Comparative Effectiveness Research Trial of Alzheimer's Disease Drugs

TypeinterventionalSponsorIndiana UniversityRan2011 to 2015Enrolled200ConditionsDementia, Alzheimer's DiseaseArmsDonepezil, Galantamine, Rivastigmine
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Review
  7. Review
  8. Review
  9. Review
  10. Article
  11. Article
  12. Alzheimer's disease medication use and adherence patterns by race and ethnicity.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023
    Article
  13. Neurotransmitters in Prevention and Treatment of Alzheimer's Disease.International journal of molecular sciences · 2023
    Review
  14. Article
  15. Review
  16. Review
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Noll L CampbellDepartment of Pharmacy Practice, Purdue University School of Pharmacy, West Lafayette, Indiana.
Anthony J PerkinsCenter for Healthcare Innovation and Implementation Science, Indianapolis, Indiana.
Sujuan GaoIndiana University Center for Aging Research, Indianapolis, Indiana.
Todd C SkaarDepartment of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Lang LiDepartment of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana.
Hugh C HendrieIndiana University Center for Aging Research, Indianapolis, Indiana.
Nicole FowlerIndiana University Center for Aging Research, Indianapolis, Indiana.
Christopher M CallahanIndiana University Center for Aging Research, Indianapolis, Indiana.
Malaz A BoustaniIndiana University Center for Aging Research, Indianapolis, Indiana.

Funding

Indiana PROSPECTR01HS019818 · AHRQ · INDIANA UNIVERSITY INDIANAPOLIS · PI DEXTER, PAUL · 2010 to 2010
$8.4M
Evaluating the Adverse Cognitive Effects of MedicationsK23AG044440 · NIA · PURDUE UNIVERSITY · PI CAMPBELL, NOLL L. · 2014 to 2018
$728k
AHRQ HHS R01 HS019818NIA NIH HHS K23 AG044440
6 · The paper itself

Abstract

BACKGROUND/

objectivesPost-marketing comparative trials describe medication use patterns in diverse, real-world populations. Our objective was to determine if differences in rates of adherence and tolerability exist among new users to acetylcholinesterase inhibitors (AChEI's).

designPragmatic randomized, open label comparative trial of AChEI's currently available in the United States.

settingFour memory care practices within four healthcare systems in the greater Indianapolis area.

participantsEligibility criteria included older adults with a diagnosis of possible or probable Alzheimer's disease (AD) who were initiating treatment with an AChEI. Participants were required to have a caregiver to complete assessments, access to a telephone, and be able to understand English. Exclusion criteria consisted of a prior severe adverse event from AChEIs.

interventionParticipants were randomized to one of three AChEIs in a 1:1:1 ratio and followed for 18 weeks. MEASUREMENTS: Caregiver-reported adherence, defined as taking or not taking study medication, and caregiver-reported adverse events, defined as the presence of an adverse event.

results196 participants were included with 74.0% female, 30.6% African Americans, and 72.9% who completed at least twelfth grade. Discontinuation rates after 18 weeks were 38.8% for donepezil, 53.0% for galantamine, and 58.7% for rivastigmine (P = .063) in the intent to treat analysis. Adverse events and cost explained 73.1% and 25.4% of discontinuation. No participants discontinued donepezil due to cost. Adverse events were reported by 81.2% of all participants; no between-group differences in total adverse events were statistically significant.

conclusionsThis pragmatic comparative trial showed high rates of adverse events and cost-related non-adherence with AChEIs. Interventions improving adherence and persistence to AChEIs may improve AD management.

trial registrationClinicaltrials.gov: NCT01362686 (https://clinicaltrials.gov/ct2/show/NCT01362686).

Indexed as

Drug-Related Side Effects and Adverse ReactionsAgedAged, 80 and overAlzheimer DiseaseCholinesterase InhibitorsDonepezilDrug CostsEthnicityFemaleGalantamineHumansIndansIndianaMaleMedication AdherencePiperidinesCholinesterase InhibitorsDonepezilGalantamineIndansPiperidinesRivastigmineAlzheimer'sclinical caredementia

Identifiers

PMID28295141
PMCPMC6604617

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.