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Persistence with anti-dementia medications: a systematic review and meta-analysis
Mohammad Sistanizad1,2, Gregory M Peterson1, Tristan Ling1
1University of Tasmania, School of Pharmacy and Pharmacology, Hobart, Australia.
Age and Ageing
|June 3, 2025
Summary
Persistence with anti-dementia drugs (ADDs) is low, with only 49% of patients continuing treatment at 12 months. Improving adherence to ADDs is crucial for better dementia patient outcomes.
Area of Science:
- Pharmacology
- Geriatrics
- Public Health
Background:
- Suboptimal persistence with anti-dementia drugs (ADDs) is linked to adverse outcomes in dementia patients, including faster disease progression and increased healthcare use.
- Understanding real-world persistence rates and influencing factors is critical for improving dementia care.
Purpose of the Study:
- To systematically review real-world persistence rates with anti-dementia drugs (ADDs).
- To identify factors influencing patient persistence with anti-dementia drug therapy.
Main Methods:
- A systematic review and meta-analysis following Cochrane and PRISMA guidelines.
- Searched multiple databases (Medline, Embase, PsycINFO, CINAHL) for studies published between January 1995 and February 2024.
- Calculated pooled persistence rates using random-effects models and explored heterogeneity through meta-regression.
Main Results:
- Included 68 studies with 684,493 participants aged 50+ receiving ADDs.
- The mean 12-month persistence rate was 49% (95% CI: 42%-56%).
- Higher persistence was observed when a permissible gap for refills was not required (67%), for memantine (61%), in studies from 2011-2015 (54%), and in European studies (57%).
Conclusions:
- Meta-analysis indicates generally low persistence with ADDs, influenced by evaluation methods.
- Targeted interventions are needed to enhance ADD persistence and improve dementia patient outcomes.
- A standardized framework for measuring persistence is recommended to improve research consistency.
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