Kim Hee Jin, Shim Yong S, Park Kee Hyung, Lee Chan Nyoung, Jung San, Yoon Soo Jin, Jeong Seul Ki, Jeong Jee Hyang, Choi Seong Hye, Kim Eun Joo, Jang Jae Won, Kang Kyunghun, Yang YoungSoon, Kim SangYun
Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Clin Neurol. 2021 Jul;17(3):368-375. doi: 10.3988/jcn.2021.17.3.368.
Reportedly 30-50% of patients being treated for chronic illnesses do not adhere to their medication regimen. We assessed the impact of a nurse-led education program for caregivers of Korean de novo Alzheimer's disease patients who had newly been prescribed donepezil.
This multicenter study analyzed 93 participants in a caregiver education group and 92 participants in a caregiver no-education group. At every visit up to the end of the study (1 year), caregivers in the education group were given educational brochures regarding Alzheimer's disease and the efficacy and adverse events of donepezil treatment. The primary endpoint was the discontinuation rate of donepezil treatment during the 1-year observation period. The secondary endpoints included the effect of education on compliance with donepezil treatment assessed at each visit using a clinician rating scale (CRS) and visual analog scale (VAS), and changes from baseline in cognitive assessment tests.
The donepezil discontinuation rates at 1 year were 5.38% (5/93) and 6.52% (6/92) in the caregiver education and no-education groups, respectively (=0.742). No significant between-group differences in donepezil compliance rates on the CRS and VAS were observed, but significant changes were observed in some cognitive tests from baseline to the end of the study.
Caregiver education had no significant effect on treatment discontinuation, but this may have been due to the low severity of cognitive impairment among the included population at baseline. In addition, the low discontinuation rates meant that no significant difference in treatment compliance was observed.
据报道，30%-50%接受慢性病治疗的患者不遵守其药物治疗方案。我们评估了一项由护士主导的教育项目对新处方多奈哌齐的韩国初发阿尔茨海默病患者照料者的影响。
这项多中心研究分析了93名照料者教育组参与者和92名非照料者教育组参与者。在研究结束（1年）前的每次随访中，教育组的照料者会收到关于阿尔茨海默病以及多奈哌齐治疗的疗效和不良事件的教育手册。主要终点是1年观察期内多奈哌齐治疗的停药率。次要终点包括使用临床医生评定量表（CRS）和视觉模拟量表（VAS）在每次随访时评估教育对多奈哌齐治疗依从性的影响，以及认知评估测试相对于基线的变化。
照料者教育组和非教育组1年时的多奈哌齐停药率分别为5.38%（5/93）和6.52%（6/92）（P=0.742）。在CRS和VAS上，未观察到两组之间多奈哌齐依从率的显著差异，但从基线到研究结束，在一些认知测试中观察到了显著变化。
照料者教育对治疗停药没有显著影响，但这可能是由于纳入人群基线时认知障碍的严重程度较低。此外，低停药率意味着未观察到治疗依从性的显著差异。
