Donepezil Adherence, Persistence and Time to First Discontinuation in a Three-Year Follow-Up of Older People

Henry C. Ndukwe, Prasad S. Nishtala

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: Donepezil is indicated for the management of mild to moderate dementia, particularly in Alzheimer's disease. Several studies have described low adherence rates with donepezil. Aim: To examine and measure donepezil adherence, persistence and time to first discontinuation in older New Zealanders. Methods: An inception cohort of 1,999 new users of donepezil, aged 65 years or older, were identified from the Pharmaceutical Collections and National Minimum Dataset from 1 November 2010 to 31 December 2013. Kaplan-Meier curves and Cox regression analysis were used to estimate the cumulative probability and risk of time to first discontinuation of donepezil therapy. Results: The mean age of the cohort was 79.5 ± 6.4 years and included 42.7% females. Adherence was high (89.0%), while the proportion of donepezil dispensings (81.0-32.5%) declined between 6 and 36 months. Persistence between the 1st and 6th dispensing visit decreased by 19.0%, and 11.0% of the total cohort had a gap of 31 days or more. The adjusted risk of time to first discontinuation in the non-adherent group was 2.2 times (95% CI 1.9-2.6) that of the adherent group. Conclusions: The non-adherent new donepezil users, on average, discontinued faster than the adherent group. Time to first discontinuation in this study was higher compared to discontinuation rates observed in clinical trials.

Original languageEnglish
Pages (from-to)482-491
Number of pages10
JournalDementia and Geriatric Cognitive Disorders Extra
Volume5
Issue number3
DOIs
Publication statusPublished - 4 Sep 2015

Keywords

  • Adherence
  • Discontinuation
  • Donepezil
  • Geriatric epidemiology
  • Older people
  • Persistence
  • Population-based study

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Psychiatry and Mental health

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