Medication compliance in Singaporean patients with Alzheimer's disease.
- Author:
Zheng Kang LUM
1
;
Ma Serrie P SUMINISTRADO
1
;
N VENKETASUBRAMANIAN
2
;
M Kamran IKRAM
3
;
Christopher CHEN
1
Author Information
- Publication Type:Journal Article
- Keywords: Alzheimer’s disease; NMDA receptor antagonist; acetylcholinesterase inhibitors; compliance
- MeSH: Aged; Aged, 80 and over; Alzheimer Disease; drug therapy; epidemiology; psychology; Caregivers; Cholinesterase Inhibitors; therapeutic use; Drug Costs; Female; Humans; Interdisciplinary Communication; Male; Medication Adherence; Middle Aged; Patient Compliance; Quality of Life; Receptors, N-Methyl-D-Aspartate; antagonists & inhibitors; Retrospective Studies; Singapore; epidemiology; Treatment Outcome
- From:Singapore medical journal 2019;60(3):154-160
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Singapore has a rapidly ageing population and an increasing prevalence of Alzheimer's disease (AD). Compliance to AD medications is associated with treatment effectiveness. We investigated compliance to acetylcholinesterase inhibitors (AChEIs) and N-methyl-D-aspartate (NMDA) receptor antagonist and treatment persistence among patients seen at the General Memory Clinic of National University Hospital, Singapore. We also identified the reasons for non-compliance.
METHODS:Patients seen at the General Memory Clinic between 1 January 2013 and 31 December 2014, who were prescribed AChEIs and NMDA receptor antagonist, were included in this retrospective cohort study. Non-compliance to medications was indirectly measured by failure to renew prescription within 60 days of the last day of medication supplied by the previous prescription. The reasons for non-compliance were identified.
RESULTS:A total of 144 patients were included. At one year, 107 patients were compliant to AD medications, while 37 patients were non-compliant. Around 60% of the non-compliant patients discontinued the use of AD medications within the first six months, and the mean persistent treatment period among this group of patients was 10.3 ± 3.5 months. The main reason for non-compliance was patients' and caregivers' perception that memory loss was of lower priority than other coexisting illnesses. Other reasons for non-compliance included side effects of medications (18.9%), perceived ineffectiveness of treatment (16.2%), inability to attend clinic (5.4%) and high cost of medications (2.7%).
CONCLUSION:Our findings suggest that the reasons for medication non-compliance can be identified early. Better compliance may be achieved through a multidisciplinary approach to patient education.
