Moon Yeonsil, Lim Jae Sung, Lee Chan Nyoung, Choi Hojin
Department of Neurology, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Korea.
Dement Neurocogn Disord. 2020 Dec;19(4):152-160. doi: 10.12779/dnd.2020.19.4.152.
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.
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.
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.
The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.
适当的药物治疗可使认知障碍患者及其照料者维持其认知功能和生活质量。因此，必须确定药物管理以及影响该疾病管理实施方式的因素。在本研究中，我们旨在评估韩国患者认知障碍药物治疗不依从（MNA）或药物过度使用（DOC）的频率，并提取包括人口统计学和社会特征、血管危险因素以及认知状态等显著变量，用于诊断MNA和DOC。
我们通过对获得性认知障碍患者的认知增强（HIQ）活动，调查了2019年3月至2019年6月期间年龄在50岁以上的患者。MNA被定义为被归类为患有认知障碍但未服用任何与认知相关药物的参与者，而DOC被定义为认知正常但正在服用与认知相关药物的参与者。
我们纳入了10767名患者。MNA组由337名参与者组成，而DOC组包括1107名参与者。能够区分MNA组与正常行为组的因素是年龄、教育程度、性别以及韩国版简易精神状态检查表（K-MMSE）总分。能够区分DOC组与正常用药行为组的因素是年龄、性别、居住差异、痴呆筛查测试经历以及K-MMSE总分。
必须了解导致痴呆药物管理不足的潜在因素，并且需要进行干预或提供支持以实现安全的药物管理。
