Alzheimer's disease medication use and adherence patterns by race and ethnicity

Abstract

Background:We examined racial and ethnic differences in medication use for a representative US population of patients with Alzheimer's disease and related dementias (ADRD). Methods:We examined cholinesterase inhibitors and memantine initiation, nonadherence, and discontinuation by race and ethnicity, using data from the 2000-2016Health and Retirement Study linked with Medicare and Medicaid claims.Results: Among newly diagnosed ADRD patients (n = 1299), 26% filled an ADRD prescription ≤90 days and 36% ≤365 days after diagnosis. Among individuals initiating ADRD-targeted treatment (n = 1343), 44% were non-adherent and 24% discontinued the medication during the year after treatment initiation. Non-Hispanic Blacks were more likely than Whites to not adhere to ADRD medication therapy (odds ratio: 1.50 [95% confidence interval: 1.07-2.09]).Discussion: Initiation of ADRD-targeted medications did not vary by ethnoracial group, but non-Hispanic Blacks had lower adherence than Whites. ADRD medication non-adherence and discontinuation were substantial and may relate to cost and access to care.

Effects of Medicare Part D medication therapy management on racial/ethnic disparities in adherence to antidementia medications among patients with Alzheimer's disease and related dementias: An observational study

“…A PDC threshold of 0.80 was selected due to its strong association with hospitalizations, health care costs, and clinical outcomes among patients with chronic conditions. 34 , 35 , 36 , 37 Furthermore, 0.80 as an adherence threshold is widely accepted based on recent studies on antidementia medications 38 , 39 and the Medicare Part D Star Ratings program. 40 In a sensitivity analysis, PDC thresholds of 0.70 and 0.90 were analyzed to determine the effects of varying adherence thresholds.…”

Exploring patient medication adherence and data mining methods in clinical big data: A contemporary review

“…established that CRN fluctuations are not tethered to disease severity, financial standing, or insurance coverage, underscoring evolving behaviors in the US aging populace with broader sociopolicy ramifications. Delving into the 2000–2016 HRS, Olchanski et al 60 . elucidated disparities in medication practices among Alzheimer's and related dementia (ADRD) patients across racial and ethnic lines.…”

“…Zhang et al 59 established that CRN fluctuations are not tethered to disease severity, financial standing, or insurance coverage, underscoring evolving behaviors in the US aging populace with broader sociopolicy ramifications. Delving into the 2000-2016 HRS, Olchanski et al 60…”