Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

Brady, Roseanna; Weinman, John

doi:10.1159/000347140

Cited by 43 publications

(38 citation statements)

References 111 publications

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“…There are unique challenges when treating older patients suffering from significant cognitive impairment [27][28][29] as they exhibit many of the characteristics associated with worse adherence (for example, impaired memory and executive functioning, depressed mood, functional limitations, comorbidities, complex drug regimens, and increased risk for adverse effects). [30][31][32][33] They are also vulnerable to contextual factors associated with poor adherence and persistence (for example, living alone, limited finances, and barriers to accessing health care). 27,28,31 Other factors contributing to a heightened risk of nonadherence in this group include limited insight (often coexisting with an inflated sense of self-efficacy), 28 comprehension difficulties, and reliance on the availability of others for assistance in the administration and monitoring of medications.…”

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

“…27,28,31 Other factors contributing to a heightened risk of nonadherence in this group include limited insight (often coexisting with an inflated sense of self-efficacy), 28 comprehension difficulties, and reliance on the availability of others for assistance in the administration and monitoring of medications. 27,30 In our paper, we review the literature on the rates and associated determinants of adherence and persistence with dementia pharmacotherapy. To date, research has largely focused on ChEI persistence (that is, how long the patient continues to follow the regimen) rather than overall measures of adherence (for example, average percentage of medication consumed during select time periods).…”

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

“…28 Effective strategies to enhance adherence and persistence will likely incorporate multiple components, including education. 27,28,30 A recent Japanese study suggested improvements may arise from a pharmacist-led consultation service directed at providing information to patients and families about the disease coupled with what are realistic expectations with pharmacotherapy. 92 While maximizing tolerability and ease of use (including consideration of the patient's daily preferences) will likely be helpful, our review indicates that the quality of communication and frequency of interaction between physician and patient and (or) their caregiver are important modifiable determinants of both persistence and adherence.…”

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confidence: 99%

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Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

et al. 2014

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This paper provides a comprehensive review of studies examining adherence and (or) persistence with dementia pharmacotherapy during the past decade, including a summary of the key patient-, drug-, system-, and provider-level factors associated with these measures. Estimates of adherence and 1-year persistence to these drugs have ranged from 34% to 94% and 35% to 60%, respectively. Though many studies reported nonsignificant associations, there are data suggesting that patient age, sex, ethnoracial background, socioeconomic status, and region-specific reimbursement criteria, as well as the extent and quality of interactions among patients, caregivers, and providers, may influence persistence with pharmacotherapy. As many studies relied on administrative data, limited information was available regarding the relevance of patient's cognitive and functional status or the importance of caregiver involvement or assistive devices to adherence or persistence. W W WPersistance et observance de la pharmacothérapie de la démence : pertinence des facteurs liés au patient, au fournisseur, et au système Cet article offre une revue détaillée des études examinant l'observance et (ou) la persistance de la pharmacothérapie de la démence au cours des dix dernières années, dont un résumé des principaux facteurs au niveau du patient, du médicament, du système et du fournisseur qui sont associés à ces mesures. Les estimations de l'observance et de la persistance d'un an à ces médicaments allaient de 34 % à 94 % et de 35 % à 60 %, respectivement. Même si de nombreuses études faisaient état d'associations non significatives, des données suggèrent que l'âge, le sexe, les origines ethnoraciales, le statut économique des patients et leurs critères de remboursement régionaux, ainsi que l'étendue et la qualité des interactions entre patients, soignants, et fournisseurs peuvent influencer la persistance de la pharmacothérapie. Comme bon nombre d'études s'appuyaient sur des données administratives, l'information disponible était limitée en ce qui concerne la pertinence de l'état cognitif et fonctionnel du patient, ou l'importance de l'implication du soignant ou des dispositifs d'assistance à l'observance ou à la persistance. In 2008, the estimated number of people with dementia in Canada was nearly half a million.2 Ensuring appropriate pharmacotherapy is an important component of care for people with dementia.3,4 ChEIs (for example, donepezil, rivastigmine, and galantamine) and the N-methyl-daspartate receptor antagonist memantine are approved for the symptomatic treatment of AD. 3,4 Recommendations made at the fourth CCCDTD (in 2012) included offering all people with AD a trial of a ChEI unless there are contraindications, using these agents for Parkinson disease dementia, and considering memantine for AD at a moderateto-severe stage. 5Investigating adherence and persistence with dementia pharmacotherapy is important in understanding both the therapeutic benefits and the cost-effectiveness of these medications. As symptomatic therapies, trea...

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Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

Section: Overview Of Studies Examining Persistence and Adherencementioning

confidence: 99%

mentioning

confidence: 99%

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Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

et al. 2014

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“…Anticholinesterase inhibitors are the cognitive enhancing medications for treating mild to moderate dementia of Alzheimer's disease and inhibits the cholinesterase enzyme that brings down acetylcholine, a neurotransmitter [2]. However, in general, untoward adverse reactions to drugs can lead to failure in achieving better therapeutic outcomes, prolongs hospital stay and increased healthcare expenditure.…”

Section: Introductionmentioning

confidence: 99%

A Single Case Report on Hyponatremia Seizure Induced by Acetylcholinesterase Inhibitors

Shareef¹,

Joseph²,

Adithi

2017

Int J Pharm Pharm Sci

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Donepezil and memantine are the acetylcholinesterase inhibitors most commonly used in clinical practice for the management of mild-moderate dementia in Alzheimer's disease. Electrolyte abnormalities associated with the drugs are commonly encountered in daily clinical practice and often can lead to seizures. Hyponatremia is an uncommon adverse effects of acetylcholinesterase inhibitors. Here we present a case on hyponatremia seizure due to the syndrome of inappropriate antidiuretic hormone (SIADH) caused by the acetylcholinesterase inhibitor donepezil and memantine as other likely causes were ruled out by appropriate investigations. The causality assessment needed to be done according to Naranjo algorithm was found to be 'probable' and the level of severity according to the Hartwig scale was 'Level 5'.

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“…At present, four drugs are used for the symptomatic treatment of AD, and three of them are classified as inhibitors of ChEs. Inhibitors of acetylcholinesterase should increase the efficiency of cholinergic transmission by preventing the hydrolysis of released acetylcholine [12]. Nowadays, suitable AChE inhibitors are the drugs most frequently used for AD treatment.…”

Section: Introductionmentioning

confidence: 99%

Electrochemical Sensors for the Estimation of the Inhibitory Effect of Phenylcarbamates to Cholinesterase

et al. 2015

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Abstract:The inhibitory effect of nine phenylcarbamates with various substituents was studied. For this purpose, electrochemical sensors were applied under two different conditions: if an enzyme was present in the solution or if the enzyme was immobilized onto the electrode surface. In both cases, 3-[(ethoxycarbonyl)amino]phenyl (4-chlorophenyl)carbamate was found as the most effective inhibitor for butyrylcholinesterase. The best inhibitors for acetylcholinesterase were determined as well, depending on the used method. Thus, 3-[(butoxycarbonyl)-amino]phenyl phenylcarbamate with the enzyme present in the solution and 3-[(ethoxycarbonyl)amino]phenyl (3-methylphenyl)carbamate when the enzyme was immobilized onto the electrode surface were evaluated as the most effective inhibitors. Michaelis constants as well as maximum reaction rates were calculated and assessed.

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Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review

Cited by 43 publications

References 111 publications

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

Persistence and Adherence with Dementia Pharmacotherapy: Relevance of Patient, Provider, and System Factors

A Single Case Report on Hyponatremia Seizure Induced by Acetylcholinesterase Inhibitors

Electrochemical Sensors for the Estimation of the Inhibitory Effect of Phenylcarbamates to Cholinesterase

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