OBJECTIVES

Medication adherence is important for the management of Alzheimer’s disease and related dementias (ADRD). This study aimed to identify the association between satisfaction with quality of care and anti-dementia medication adherence among elderly adults with ADRD.

METHODS

A pooled cross-sectional study was designed using data from the Medicare Current Beneficiary Survey between 2015 and 2017. The proportion of days covered (PDC) was used to identify medication adherence. Individuals with a PDC equal to or greater than 0.8 were labeled as adherent, while those with a PDC less than 0.8 were labeled as nonadherent. Anti-dementia medications included cholinesterase inhibitors (ChEIs) and N-methyl-D-aspartate (NMDA)-receptor antagonists. Satisfaction with quality of care was measured by questions on overall quality of care, medical information, follow-up care, overall health, needs met, night/weekend services, and out-of-pocket costs. Those responding “dissatisfied” or “very dissatisfied” were considered as having received unsatisfactory quality of health care. Multivariable logistic regression models controlling for covariates were implemented. Subgroup analysis was conducted for ChEIs and NMDA-receptor antagonists.

RESULTS

A total of 4,003 patients with ADRD were identified, 659 (16.5%) of whom were adherent to anti-dementia medications. Compared to ADRD patients with satisfactory quality of care, those with unsatisfactory quality of care were less likely to be adherent to anti-dementia medications (OR=0.65, 95% CI, 0.46–0.90). In addition, Hispanics were more likely to be adherent compared to non-Hispanic whites (OR=1.86, 95% CI, 1.06–3.28). Subgroup analysis showed that for ChEIs, patients with unsatisfactory quality of care were less likely to be adherent than those with unsatisfactory quality of care (OR=0.66, 95% CI, 0.44–0.98).

CONCLUSIONS

Patients with ADRD with unsatisfactory quality of care are less likely to be adherent to anti-dementia medications. Measures should be taken to improve the satisfaction with quality of care among paitents with ADRD, thus promoting the use of anti-dementia medications and facilitating ADRD management.