J Clin Neurol.  2021 Jul;17(3):368-375. 10.3988/jcn.2021.17.3.368.

Impact of an Education Program for Caregivers of Patients with Alzheimer’s Disease on Treatment Discontinuation and Compliance in Korea

  • 1Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea
  • 2Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, Korea
  • 4Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • 5Department of Neurology, Hallym University Medical Center, Kangnam Sacred Heart Hospital, Seoul, Korea
  • 6Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
  • 7Department of Neurology, Chonbuk National University School of Medicine, Jeonju, Korea
  • 8Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea
  • 9Department of Neurology, Inha University School of Medicine, Incheon, Korea
  • 10Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
  • 11Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
  • 12Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
  • 13Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
  • 14Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea


Background and Purpose
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 (p=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.


Alzheimer’s disease; caregiver education; dementia; Korea; treatment compliance
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