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Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence

AIM: Donepezil is widely used to delay the progression of cognitive dysfunction in patients with Alzheimer’s disease (AD), but the efficacy of pharmacotherapy is often reduced by poor adherence to medication. In order to improve adherence by providing information about AD and the significance of pha...

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Autores principales: Watanabe, Norio, Yamamura, Keiko, Suzuki, Yusuke, Umegaki, Hiroyuki, Shigeno, Katsuro, Matsushita, Ryo, Sai, Yoshimichi, Miyamoto, Ken-ichi, Yamada, Kiyofumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437908/
https://www.ncbi.nlm.nih.gov/pubmed/22969291
http://dx.doi.org/10.2147/PPA.S34984
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author Watanabe, Norio
Yamamura, Keiko
Suzuki, Yusuke
Umegaki, Hiroyuki
Shigeno, Katsuro
Matsushita, Ryo
Sai, Yoshimichi
Miyamoto, Ken-ichi
Yamada, Kiyofumi
author_facet Watanabe, Norio
Yamamura, Keiko
Suzuki, Yusuke
Umegaki, Hiroyuki
Shigeno, Katsuro
Matsushita, Ryo
Sai, Yoshimichi
Miyamoto, Ken-ichi
Yamada, Kiyofumi
author_sort Watanabe, Norio
collection PubMed
description AIM: Donepezil is widely used to delay the progression of cognitive dysfunction in patients with Alzheimer’s disease (AD), but the efficacy of pharmacotherapy is often reduced by poor adherence to medication. In order to improve adherence by providing information about AD and the significance of pharmacotherapy, the Donepezil Outpatient Consultation Service (DOCS) was set up. The influence of this service on medication persistence was assessed in the present study. METHODS: Among outpatients starting donepezil therapy, we enrolled 59 patients between April 2008 and September 2010 before establishment of the DOCS (non-DOCS group) and 52 patients between October 2010 and March 2012 who attended the DOCS (DOCS group). Each patient’s and their caregiver’s understanding about the clinical features of AD and pharmacotherapy with donepezil were also assessed. Their understanding was compared before and after the DOCS, and the 1-year medication persistence rate and the reasons for discontinuation were also investigated. RESULTS: The 1-year medication persistence rate was significantly higher in the DOCS group than in the non-DOCS group (73.1% vs 49.2%, P = 0.008). We examined the association of medication persistence with age, sex, clinical dementia rating, living alone, and attending the DOCS. As a result, medication persistence was significantly higher in patients attending the DOCS. The main reasons for discontinuation of donepezil were transfer elsewhere (11) and gastrointestinal side effects (5) in the non-DOCS group, and transfer (9) and gastrointestinal side effects (3) in the DOCS group. The overall score for understanding was 2.5 ± 1.7 before attending the DOCS and it increased significantly to 5.7 ± 0.7 afterward (P < 0.001). CONCLUSION: The DOCS consultation provided by hospital pharmacists for AD patients and their caregivers improved understanding about the clinical features of dementia and provided pharmacological knowledge about antidementia drugs, leading to better adherence to pharmacotherapy that could maximize its effect.
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spelling pubmed-34379082012-09-11 Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence Watanabe, Norio Yamamura, Keiko Suzuki, Yusuke Umegaki, Hiroyuki Shigeno, Katsuro Matsushita, Ryo Sai, Yoshimichi Miyamoto, Ken-ichi Yamada, Kiyofumi Patient Prefer Adherence Original Research AIM: Donepezil is widely used to delay the progression of cognitive dysfunction in patients with Alzheimer’s disease (AD), but the efficacy of pharmacotherapy is often reduced by poor adherence to medication. In order to improve adherence by providing information about AD and the significance of pharmacotherapy, the Donepezil Outpatient Consultation Service (DOCS) was set up. The influence of this service on medication persistence was assessed in the present study. METHODS: Among outpatients starting donepezil therapy, we enrolled 59 patients between April 2008 and September 2010 before establishment of the DOCS (non-DOCS group) and 52 patients between October 2010 and March 2012 who attended the DOCS (DOCS group). Each patient’s and their caregiver’s understanding about the clinical features of AD and pharmacotherapy with donepezil were also assessed. Their understanding was compared before and after the DOCS, and the 1-year medication persistence rate and the reasons for discontinuation were also investigated. RESULTS: The 1-year medication persistence rate was significantly higher in the DOCS group than in the non-DOCS group (73.1% vs 49.2%, P = 0.008). We examined the association of medication persistence with age, sex, clinical dementia rating, living alone, and attending the DOCS. As a result, medication persistence was significantly higher in patients attending the DOCS. The main reasons for discontinuation of donepezil were transfer elsewhere (11) and gastrointestinal side effects (5) in the non-DOCS group, and transfer (9) and gastrointestinal side effects (3) in the DOCS group. The overall score for understanding was 2.5 ± 1.7 before attending the DOCS and it increased significantly to 5.7 ± 0.7 afterward (P < 0.001). CONCLUSION: The DOCS consultation provided by hospital pharmacists for AD patients and their caregivers improved understanding about the clinical features of dementia and provided pharmacological knowledge about antidementia drugs, leading to better adherence to pharmacotherapy that could maximize its effect. Dove Medical Press 2012-08-28 /pmc/articles/PMC3437908/ /pubmed/22969291 http://dx.doi.org/10.2147/PPA.S34984 Text en © 2012 Watanabe et al, 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
Watanabe, Norio
Yamamura, Keiko
Suzuki, Yusuke
Umegaki, Hiroyuki
Shigeno, Katsuro
Matsushita, Ryo
Sai, Yoshimichi
Miyamoto, Ken-ichi
Yamada, Kiyofumi
Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title_full Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title_fullStr Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title_full_unstemmed Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title_short Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence
title_sort pharmacist-based donepezil outpatient consultation service to improve medication persistence
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437908/
https://www.ncbi.nlm.nih.gov/pubmed/22969291
http://dx.doi.org/10.2147/PPA.S34984
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