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Pharmacist-based Donepezil Outpatient Consultation Service to improve medication persistence

机译：基于药剂师的多奈哌齐门诊咨询服务，以改善药物持久性

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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.
机译：目的：多奈哌齐被广泛用于延缓阿尔茨海默氏病（AD）患者的认知功能障碍的进展，但药物治疗的依从性差，往往会降低药物治疗的效果。为了通过提供有关AD和药物治疗意义的信息来提高依从性，成立了Donepezil门诊咨询服务（DOCS）。方法：在开始多奈哌齐治疗的门诊患者中，我们纳入了2008年4月至2010年9月建立DOCS（非DOCS组）之前的59位患者和52位于2010年10月之间的52位患者。和2012年3月参加了DOCS（DOCS组）。还评估了每个患者及其护理人员对AD临床特征和多奈哌齐药物治疗的理解。比较他们在DOCS前后的理解，并调查了1年药物持续性发生率和停药原因。结果：DOCS组1年药物持续性发生率显着高于非DOCS组。 （73.1％vs 49.2％，P = 0.008）。我们检查了药物持久性与年龄，性别，临床痴呆等级，独自生活和参加DOCS的关联。结果，参加DOCS的患者的药物持久性明显更高。停用多奈哌齐的主要原因是非DOCS组中的其他部位转移（11）和胃肠道副作用（5），DOCS组中的转移（9）和胃肠道副作用（3）。参加DOCS之前，患者的总体理解得分为2.5±1.7，之后显着提高至5.7±0.7（P <0.001）。结论：医院药剂师为AD患者及其护理人员提供的DOCS咨询可增进对AD患者临床特征的了解痴呆症，并提供了有关抗痴呆药的药理知识，从而更好地坚持药物疗法，从而可以最大程度地发挥其作用。

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