title: Factors associated with persistence of cholinesterase inhibitor treatments in the elderly.
abstract: OBJECTIVE
  To identify factors associated with one-year persistence of cholinesterase inhibitor (ChI) treatments.
  
  
  METHODS
  A retrospective cohort study was performed using the reimbursement database of the Echantillon Généraliste des Bénéficiaires, a 1/96(e) representative sample of subjects affiliated to the French National Healthcare Insurance System. Among this, patients who initiated a ChI treatment between 1 January 2004 and 31 December 2005 and for whom 1 year of follow-up in the database after treatment initiation was available were identified. One-year persistence of ChI treatment was defined as an ongoing treatment without dispensing interval exceeding 60 consecutive days during the 12 months following treatment initiation. Drug switches were not considered as treatment discontinuation. A multivariate logistic regression was conducted to identify, among patients characteristics (sociodemographic, drug uses), factors associated with one-year persistence of ChI treatments.
  
  
  RESULTS
  Among the 942 patients who initiated a treatment with ChI during the study period, 72.4% were women; mean age was 79.6 years (SD = 7.4). Patients used eight other different drugs in median (Inter-Quartile Range: 5-11); 63.7% used psychotropics, 63.6% used cardiovascular drugs. One-year persistence of ChI treatments was estimated at 45.3%. Persistence of ChI treatments was lower in patients aged 80 years and over (OR = 0.74, 95%CI: 0.57-0.96); it was higher in patients using antidepressants at ChI treatment initiation (OR = 1.38, 95%CI: 1.05-1.82).
  
  
  CONCLUSIONS
  One-year persistence of ChI treatment was estimated at 45.3% in this French sample. To optimize persistence of ChI treatment in the demented, patients poorly symptomatic and/or aged over 80 years should be especially monitored.
authors.affiliation: Faculty of Pharmacy, University of Montreal, QC, Canada. antoine.pariente@pharmaco.u-bordeaux2.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Pariente
authors.forename: Marion
authors.initials: M
authors.lastname: Pinet
authors.forename: Yola
authors.initials: Y
authors.lastname: Moride
authors.forename: Yvon
authors.initials: Y
authors.lastname: Merlière
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Annie
authors.initials: A
authors.lastname: Fourrier-Réglat
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D002800:Cholinesterase Inhibitors