Changes in dementia treatment patterns associated with changes in the National Policy in South Korea among patients with newly diagnosed Alzheimer's disease between 2011 and 2017: results from the multicenter, retrospective CAPTAIN study

被引：6

作者：

Kim, Young Jin ^{[1
]}

So, Ki-Youn ^{[2
]}

Lee, Hyo Min ^{[3
]}

Hahn, Changtae ^{[4
]}

Song, Seung-Hoon ^{[5
]}

Lee, Yong-Seok ^{[6
]}

Kim, Sang Woo ^{[7
]}

Park, Heui Cheun ^{[8
]}

Ryu, Jaehyung ^{[9
]}

Lee, Jung Seok ^{[10
]}

Kang, Min Ju ^{[11
]}

Kim, Jinran ^{[12
]}

Lee, Yoona ^{[12
]}

Lee, Jun Hong ^{[13
]}

机构：

[1] Sungae Gen Hosp, Seoul, South Korea

[2] Namwon Med Ctr, Namwon Si, Jeollabuk Do, South Korea

[3] Daegu Fatima Hosp, Daegu, South Korea

[4] Daejeon St Marys Hosp, Daejeon, South Korea

[5] Baekje Gen Hosp, Nonsan Si, Chungcheongnam, South Korea

[6] Seoul Natl Univ, Boramae Med Ctr, Seoul Metropolitan Govt, Seoul, South Korea

[7] Busan St Marys Hosp, Busan, South Korea

[8] Andong Med Grp Hosp, Andong Si, Gyeongsangbuk D, South Korea

[9] Yeosu Chonnam Hosp, Yeosu Si, Jeollanam Do, South Korea

[10] Jeju Natl Univ Hosp, Jeju Si, Jeju Do, South Korea

[11] Vet Healthcare Syst Med Ctr, Seoul, South Korea

[12] Eisai Korea Inc, Seoul, South Korea

[13] Natl Hlth Insurance Serv Ilsan Hosp, Goyang Si, Gyeonggi Do, South Korea

来源：

BMC PUBLIC HEALTH | 2024年 / 24卷 / 01期

关键词：

Dementia; Alzheimer's disease; Treatment pattern; Medication persistence; Electronic medical records; National policy; Long-term care insurance; LTCI; OLDER-PEOPLE; CHALLENGES; HEALTH;

D O I：

10.1186/s12889-024-17671-2

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background The South Korean government has been actively involved in plans to combat dementia, implementing a series of national strategies and plans since 2008. In July 2014, eligibility for mandatory long-term care insurance (LTCI) was extended to people with dementia enabling access to appropriate long-term care including the cognitive function training program and home nursing service. This study aimed to investigate changes in treatment patterns for Alzheimer's disease (AD) between July 2011 and June 2017 which spanned the 2014 revision. Methods This multicenter, retrospective, observational study of patients with newly diagnosed AD analyzed electronic medical records from 17 general hospitals across South Korea. Based on their time of AD diagnosis, subjects were categorized into Cohort 1 (1 July 2011 to 30 June 2014) and Cohort 2 (1 July 2014 to 30 June 2017). Results Subjects (N=3,997) divided into Cohorts 1 (n=1,998) and 2 (n=1,999), were mostly female (66.4%) with a mean age of 84.4 years. Cohort 1 subjects were significantly older (P<0.0001) and had a lower number of comorbidities (P=0.002) compared with Cohort 2. Mean Mini-Mental State Examination (MMSE) scores in Cohorts 1 and 2 at the time of AD diagnosis or start of initial treatment were 16.9 and 17.1, respectively (P=0.2790). At 1 year, mean MMSE scores in Cohorts 1 and 2 increased to 17.9 and 17.4, respectively (P=0.1524). Donepezil was the most frequently administered medication overall (75.0%), with comparable rates between cohorts. Rates of medication persistence were >= 98% for acetylcholinesterase inhibitor or memantine therapy. Discontinuation and switch treatment rates were significantly lower (49.7% vs. 58.0%; P<0.0001), and mean duration of initial treatment significantly longer, in Cohort 2 vs. 1 (349.3 vs. 300.2 days; P<0.0001). Conclusions Comparison of cohorts before and after revision of the national LTCI system for dementia patients found no significant difference in mean MMSE scores at the time of AD diagnosis or start of initial treatment. The reduction in the proportion of patients who discontinued or changed their initial treatment, and the significant increase in mean duration of treatment, were observed following revision of the LTCI policy which enabled increased patient access to long-term care.

引用

页数：10

共 23 条

[1]

[Anonymous], 2022, Dementia statistics

[2] Meta-Analysis of the Prevalence of Major Depressive Disorder Among Older Adults With Dementia [J].