Variables Influencing Drug Adherence in Patients with Alzheimer's Disease

Youn, Hyunchul; Yang, Jaewon; Lee, Moon Soo; Jung, In Kwa; Jeong, Hyun Ghang; Joe, Sook Haeng; Han, Changsu; Kim, Seung Hyun

Abstract

OBJECTIVES
Many patients with Alzheimer's disease have difficulty in taking their medicine by themselves and their poor drug adherence possibly results in aggravating various symptoms. The aim of this study was to assess the variables influencing drug adherence of Alzheimer's disease patients.
METHODS
In a four-week period, 33 outpatients over 65 years old diagnosed with Alzheimer's disease were monitored. Drug adherences were assessed by the Medication Event Monitoring System (MEMS), the pill count, the clinician rating scale, and self-report. Agreements among adherence measures and the relationships between MEMS adherence and other clinical factors were assessed.
RESULTS
The adherence rates for the MEMS, the pill count, the clinician rating scale and, self-report were 51.5%, 82.8%, 82.8%, and 87.9%. The Kappa coefficients were 0.382 (pill count vs. MEMS, clinician rating scale vs. MEMS) and 0.256 (self-report vs. MEMS). Males showed better adherence than females but the other clinical variables did not show significant differences between adherence group and non-adherence group.
CONCLUSION
These findings suggest that clinicians should be concerned when assessing drug adherence in patients with Alzheimer's disease only by subjective reporting and pill counting since these methods may make patient's adherence underestimate. Clinicians should also take in mind that caregivers play an important role in improving adherence.