Vulnerable Strata to Non-Adherence and Overuse in Treatment for Patients with Cognitive Impairment

Abstract

Background and purpose: Appropriate medication treatment could enable both cognitively impaired patients and caregivers to hold on their cognitive functioning and quality of life. Thus, medication management and the factors influencing how management for this condition is carried out must be identified. In this study we aimed to evaluate the frequency of medication nonadherence (MNA) or drug overuse for cognitive impairment (DOC) and to extract significant variables, including the demographic and social characteristics, vascular risk factors, and cognitive status, for the diagnosis of MNA and DOC in Korean patients. Methods: We investigated patients aged over 50 years between March 2019 and June 2019 via the cognitive enHancement of patIents with acQuired cognitive impairment (HIQ) campaign. MNA was defined as a participant who was classified as having cognitive impairment but did not take any cognition-related drugs, whereas DOC was defined as a participant who had normal cognition but was taking cognition-related drugs. Results: We included 10,767 patients. The MNA group consisted of 337 participants, whereas the DOC group comprised 1,107 participants. The factors that could differentiate the MNA group from the normal-behavior group were age, education, sex, and the total Korean version of Mini-Mental State Examination (K-MMSE) score. The factors that could differentiate the DOC group from the normal medication-behavior group were age, sex, residential distinction, experience of a dementia screening test, and the total K-MMSE score. Conclusions: The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.