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首页> 外文期刊>Patient Preference and Adherence >Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program
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Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program

机译：国家医疗补助计划中乙酰胆碱酯酶抑制剂的持久率比较

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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.
机译：目的：比较老年人的医疗补助患者群体中胆碱酯酶抑制剂（ChEIs）之间的持久性水平。方法：采用生存分析评估ChEIs（多奈哌齐与卡巴拉汀和加兰他敏）之间停药的差异，以及患者性别的差异，结果：停药率从12个月的42.7％（95％CI = 39.9-45.5）增加到24个月的84.8％（95％CI = 82.3-87.3）。在多变量模型中，在365天之前停药没有显着差异。但是，与第一年后其他两个ChEIs的使用者相比，分配多奈哌齐的患者停药的可能性较小（RR = 0.70; CI = 0.499–0.983; p <0.04）。白人患者的停药可能性较小（RR = 0.549; 95％CI = 0.43–0.82; p = 0.0015），而性别，护理环境和年龄均与停药无关。结论：一年坚持率相似在不同的ChEI之间。在持续使用ChEI药物至少12个月的患者中，多奈哌齐的使用者在24个月后继续坚持的可能性会稍高一些。近一半的患者未能持续接受ChEI治疗至少12个月。我们的发现强调了ChEI药物的局限性以及对患有痴呆症患者的有效且可耐受的治疗选择的迫切需求。

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