In:
Journal of the American Geriatrics Society, Wiley, Vol. 64, No. 9 ( 2016-09), p. 1806-1814
Abstract:
To examine racial and ethnic differences in initiation and time to discontinuation of antidementia medication in Medicare beneficiaries. Design Retrospective cohort study. Setting Secondary analysis of 2009–10 enrollment, claims, and Part D prescription data for a 10% national sample of U.S. Medicare fee‐for‐service beneficiaries. Participants Beneficiaries aged 65 and older with Alzheimer's disease or related dementia ( ADRD ) before 2009 and no fills for antidementia medications in the first half of 2009 (N = 84,043). Measurements Initiation was defined as having one or more fills for antidementia medication in the second half of 2009 and discontinuation as a gap in coverage of 30 days or more during the year after initiation. The Andersen Behavioral Model was used to guide covariate selection. Results Overall, 3,481 (4.1%) of previous nonusers initiated antidementia medication in the second half of 2009. Of those initiating one drug class (acetylcholinesterase inhibitors ( AC h EI s) or memantine), 9% later added the other class, and 2% switched classes. Of initiators, 23% discontinued within 1 month, and 62% discontinued within 1 year. Hispanic beneficiaries were more likely than white beneficiaries to initiate (adjusted odds ratio = 1.25, 95% confidence interval ( CI ) = 1.10–1.41). Black and white beneficiaries did not differ in likelihood of initiation. Hispanic (adjusted hazard ratio ( aHR ) = 1.56, 95% CI = 1.34–1.82) and black ( aHR = 1.25, 95% CI = 1.08–1.44) beneficiaries discontinued at a faster rate than white beneficiaries. Conclusion Initiation of antidementia medications was no different in black and white beneficiaries and more likely in Hispanic beneficiaries; black and Hispanic beneficiaries discontinued at a faster rate. More research into reasons explaining these differences is needed.
Type of Medium:
Online Resource
ISSN:
0002-8614
,
1532-5415
DOI:
10.1111/jgs.2016.64.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2040494-3
