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Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program

OBJECTIVE: To compare levels of persistency between cholinesterase inhibitors (ChEIs) among a Medicaid patient population of older adults. METHODS: Survival analysis was used to assess differences in discontinuation between ChEIs (donepezil versus rivastigmine and galantamine), and for difference in...

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Autores principales: Abughosh, Susan M, Kogut, Stephen J
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770391/
https://www.ncbi.nlm.nih.gov/pubmed/19920947
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author Abughosh, Susan M
Kogut, Stephen J
author_facet Abughosh, Susan M
Kogut, Stephen J
author_sort Abughosh, Susan M
collection PubMed
description OBJECTIVE: To compare levels of persistency between cholinesterase inhibitors (ChEIs) among a Medicaid patient population of older adults. METHODS: Survival analysis was used to assess differences in discontinuation between ChEIs (donepezil versus rivastigmine and galantamine), and for difference in patient gender, age, race, and care setting. RESULTS: Rates of discontinuation increased from 42.7% (95% CI = 39.9–45.5) at 12 months to 84.8% (95% CI = 82.3–87.3) at 24 months. In multivariate models, no significant difference in discontinuation existed prior to 365 days. However, patients dispensed donepezil were less likely to discontinue as compared with users of the other two ChEIs after the first year (RR = 0.70; CI = 0.499–0.983; p < 0.04). Patients of white race were less likely to discontinue (RR = 0.549; 95% CI = 0.43–0.82; p = 0.0015), while gender, care setting, and age were not associated with discontinuation. CONCLUSIONS: One-year persistence rates were similar between different ChEIs. Among patients persisting with ChEI medication for at least 12 months, users of donepezil were slightly more likely to continue to persist at 24 months. Nearly half of patients failed to persist with ChEI therapy for at least 12 months. Our findings underscore the limitations of the ChEI medications and the urgent need for effective and tolerable therapeutic options for patients having dementia.
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spelling pubmed-27703912009-11-17 Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program Abughosh, Susan M Kogut, Stephen J Patient Prefer Adherence Original Research OBJECTIVE: To compare levels of persistency between cholinesterase inhibitors (ChEIs) among a Medicaid patient population of older adults. METHODS: Survival analysis was used to assess differences in discontinuation between ChEIs (donepezil versus rivastigmine and galantamine), and for difference in patient gender, age, race, and care setting. RESULTS: Rates of discontinuation increased from 42.7% (95% CI = 39.9–45.5) at 12 months to 84.8% (95% CI = 82.3–87.3) at 24 months. In multivariate models, no significant difference in discontinuation existed prior to 365 days. However, patients dispensed donepezil were less likely to discontinue as compared with users of the other two ChEIs after the first year (RR = 0.70; CI = 0.499–0.983; p < 0.04). Patients of white race were less likely to discontinue (RR = 0.549; 95% CI = 0.43–0.82; p = 0.0015), while gender, care setting, and age were not associated with discontinuation. CONCLUSIONS: One-year persistence rates were similar between different ChEIs. Among patients persisting with ChEI medication for at least 12 months, users of donepezil were slightly more likely to continue to persist at 24 months. Nearly half of patients failed to persist with ChEI therapy for at least 12 months. Our findings underscore the limitations of the ChEI medications and the urgent need for effective and tolerable therapeutic options for patients having dementia. Dove Medical Press 2008-02-02 /pmc/articles/PMC2770391/ /pubmed/19920947 Text en © 2008 Abughosh and Kogut, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Abughosh, Susan M
Kogut, Stephen J
Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title_full Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title_fullStr Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title_full_unstemmed Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title_short Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
title_sort comparison of persistence rates of acetylcholine-esterase inhibitors in a state medicaid program
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770391/
https://www.ncbi.nlm.nih.gov/pubmed/19920947
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