Medication compliance in Singaporean patients with Alzheimer’s disease

Lum, Zheng Kang; Suministrado, Ma Serrie P; Venketasubramanian, Narayanaswamy; Ikram, M. Kamran; Chen, Christopher

doi:10.11622/smedj.2018076

Cited by 8 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most urban participants did not start pharmacotherapy due to a fear of adverse effects and suspended AD medications because of poor curative effects. In accordance with other studies, side effects from medications, including diarrhea, nausea, sleep disturbances and ineffectiveness, contributed to non-compliance ( 9 , 19 , 29 ). Older people with comorbidities usually took multiple medications and consequently worried about health outcomes, such as longer survival, prevention of disease-specific events, and tolerable risk of adverse drug reactions.…”

Section: Discussionsupporting

confidence: 89%

“…Similar to the results of other studies, awareness of the disease and an emphasis on medication were positively related to treatment adherence ( 23 , 24 ). Moreover, challenges in obtaining financial reimbursement for drug costs may have influenced access to AD treatment, which also corroborated previous studies ( 19 , 25 ). Hence, financial support, professional training, the implementation of memory clinics and popularization of knowledge about disease among rural areas may alleviate regional gaps in pharmacotherapy adherence.…”

Section: Discussionsupporting

confidence: 87%

“…The logistic analysis of this study concentrating on rural patients illustrated that family earnings and the severity of AD influenced medication adherence. Economic factors for non-compliance to AD medications were coincident with the classification by the WHO ( 19 , 26 ). In addition, AD with memory loss and impaired executive function was closely related to medication adherence ( 21 ).…”

Section: Discussionmentioning

confidence: 84%

“…However, only 30% of rural patients in our research adhered to a medication regimen, and more than 60% of patients consistently used medication for less than a year. A previous survey indicated that the rates of medication compliance ranged from 17 to 100% among people with AD, which might be attributed to cognitive deficits in various domains, unique sociocultural backgrounds, and different reporters ( 19 – 21 ). Given that the prompt initiation of and adherence to medication regimens after diagnosis are crucial to cognitive preservation and achieving maximal treatment efficacy ( 9 , 22 ), pharmacotherapy compliance needs to be further improved in China, especially in rural areas, as it is determined by specific individual characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…Older people with comorbidities usually took multiple medications and consequently worried about health outcomes, such as longer survival, prevention of disease-specific events, and tolerable risk of adverse drug reactions. Therefore, they preferentially adhered to treatment for chronic deases other than AD, such as hypertension, diabetes mellitus and dyslipidemia ( 19 , 21 ). Moreover, negative therapeutic experiences due to adverse drug effects and the ineffectiveness of medication might be due to the mode of use and inadequate pharmaceutical form for the clinical condition, such as dysphagia ( 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Differences in treatment for Alzheimer's disease between urban and rural areas in China

Liu²,

Wan³

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

IntroductionIn China, the increasing number of people with Alzheimer's disease (AD) poses a great challenge to families and the country. Economic and cultural differences cause a urban-rural gap in medical resources. This multicenter survey aimed to investigate the real-world practice of disease treatment among people with AD.MethodsPeople with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for their treatment experience. Logistic regression was used to explore the factors that influence medication adherence in all areas, urban areas, and rural areas.ResultsIn this survey, 1,427 participants came from urban areas, and 539 participants came from rural areas. Patients in urban areas were older (mean age 74 vs. 70, p = 0.001), less frequently had mild AD (36.0 vs. 52.1%, p < 0.001), and more often were cared for at professional institutions (8.8 vs. 3.2%, p < 0.001). In terms of pharmacotherapy, 77.8% of people accepted taking lifelong medication, whereas 61.3% of patients insisted on taking medications. Although 72.0% of rural people believed in taking lifelong medication, only 30.0% adhered to drug use. The major factors that influenced medication adherence for all patients with AD were regional distribution (p < 0.001, OR = 6.18, 95% CI: 4.93–7.74) and family earnings (p = 0.003, OR = 1.22, 95% CI: 1.07–1.38). In rural areas, family earnings (p = 0.008, OR = 1.44, 95% CI: 1.10–1.89) and severity of AD (p = 0.033, OR = 1.31, 95% CI: 1.02–1.68) were the main factors. Family earnings (p = 0.038, OR = 1.16, 95% CI: 1.01–1.34) was the only factor among urban areas. Among all non-pharmaceutical activities except for cognitive intervention, the participation rates of rural patients were significantly higher than those of urban patients (p < 0.05).ConclusionAlthough national progress has been made in the public awareness of disease treatment, adequate diagnosis and medication adherence need to be prompted, especially in rural areas. Furthermore, lifelong treatment should be improved based on regional characteristics through the joint efforts of the government, health workers, and social volunteers.

show abstract

Section: Discussionsupporting

confidence: 89%