ArticleJournal of Korean medical science2025
Adherence of Anti-Dementia Medications in Alzheimer's Disease and Related Dementia: A Nationwide Cohort Study in Korea.
Article in Journal of Korean medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundReadily available treatments for Alzheimer's disease and related dementia (ADRD) include acetylcholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists. Non-adherence and early discontinuation of anti-dementia medications are prevalent issues. We aimed to investigate factors associated with suboptimal usage of anti-dementia medications in ADRD.
methodsBased on data extracted from a claim database in South Korea, 508,958 patients with ADRD who began taking anti-dementia medication between 2018 and 2020 were included. The mean possession ratio is the ratio of the sum of prescribed medication supply over one year and non-adherence is defined as mean possession ratio < 80%. Discontinuation is defined as no prescription of anti-dementia medications, or no switch to other anti-dementia medications, within 45 days after the run-out date. The cumulative incidence of discontinuation of anti-dementia medication was estimated using the Kaplan-Meier method. Factors associated with non-adherence were evaluated using logistic regression analyses.
resultsWithin the first year, the non-adherence ratio was 40.8%, while the discontinuation ratio was 43.6%, and approximately 30% of patients discontinued medication within 90 days after initiation. Younger age at diagnosis, female sex, and prescription at non-tertiary hospitals or clinics other than neurology/psychiatry were associated with increased risk of non-adherence. Compared with Seoul, a prescription issued by neurology/psychiatry departments at a tertiary hospital in other provinces was associated with a 75% higher risk of non-adherence.
conclusionStrategies targeting non-adherence are warranted to minimize disparities in the management of patients with dementia.
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