Differences in treatment for Alzheimer's disease between urban and rural areas in China
IntroductionIn China, the increasing number of people with Alzheimer's disease (AD) poses a great challenge to families and the country. Economic and cultural differences cause a urban-rural gap in medical resources. This multicenter survey aimed to investigate the real-world practice of diseas...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.996093/full |
| _version_ | 1811264485395005440 |
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| author | Bei Li Dejun Liu Qiaoqin Wan Can Sheng Xiting Wang Fangda Leng Qing Peng Ting Wang Ailian Du Feiqi Zhu Dunzhu Mima Huali Wang Hengge Xie Zhaoxia Wang Haiqiang Jin Yongan Sun |
| author_facet | Bei Li Dejun Liu Qiaoqin Wan Can Sheng Xiting Wang Fangda Leng Qing Peng Ting Wang Ailian Du Feiqi Zhu Dunzhu Mima Huali Wang Hengge Xie Zhaoxia Wang Haiqiang Jin Yongan Sun |
| author_sort | Bei Li |
| collection | DOAJ |
| description | IntroductionIn China, the increasing number of people with Alzheimer's disease (AD) poses a great challenge to families and the country. Economic and cultural differences cause a urban-rural gap in medical resources. This multicenter survey aimed to investigate the real-world practice of disease treatment among people with AD.MethodsPeople with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for their treatment experience. Logistic regression was used to explore the factors that influence medication adherence in all areas, urban areas, and rural areas.ResultsIn this survey, 1,427 participants came from urban areas, and 539 participants came from rural areas. Patients in urban areas were older (mean age 74 vs. 70, p = 0.001), less frequently had mild AD (36.0 vs. 52.1%, p < 0.001), and more often were cared for at professional institutions (8.8 vs. 3.2%, p < 0.001). In terms of pharmacotherapy, 77.8% of people accepted taking lifelong medication, whereas 61.3% of patients insisted on taking medications. Although 72.0% of rural people believed in taking lifelong medication, only 30.0% adhered to drug use. The major factors that influenced medication adherence for all patients with AD were regional distribution (p < 0.001, OR = 6.18, 95% CI: 4.93–7.74) and family earnings (p = 0.003, OR = 1.22, 95% CI: 1.07–1.38). In rural areas, family earnings (p = 0.008, OR = 1.44, 95% CI: 1.10–1.89) and severity of AD (p = 0.033, OR = 1.31, 95% CI: 1.02–1.68) were the main factors. Family earnings (p = 0.038, OR = 1.16, 95% CI: 1.01–1.34) was the only factor among urban areas. Among all non-pharmaceutical activities except for cognitive intervention, the participation rates of rural patients were significantly higher than those of urban patients (p < 0.05).ConclusionAlthough national progress has been made in the public awareness of disease treatment, adequate diagnosis and medication adherence need to be prompted, especially in rural areas. Furthermore, lifelong treatment should be improved based on regional characteristics through the joint efforts of the government, health workers, and social volunteers. |
| first_indexed | 2024-04-12T20:05:10Z |
| format | Article |
| id | doaj.art-f90c3688107b4cd09bfc1a2b42768548 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T20:05:10Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-f90c3688107b4cd09bfc1a2b427685482022-12-22T03:18:26ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.996093996093Differences in treatment for Alzheimer's disease between urban and rural areas in ChinaBei Li0Dejun Liu1Qiaoqin Wan2Can Sheng3Xiting Wang4Fangda Leng5Qing Peng6Ting Wang7Ailian Du8Feiqi Zhu9Dunzhu Mima10Huali Wang11Hengge Xie12Zhaoxia Wang13Haiqiang Jin14Yongan Sun15Department of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaHealth Division of Guard Bureau, General Office of CPC Central Committee, Beijing, ChinaSchool of Nursing, Peking University, Beijing, ChinaDepartment of Geriatrics, Peking University First Hospital, Beijing, ChinaDepartment of Geriatrics, Peking University First Hospital, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Neurology, Shenzhen Luohu People's Hospital, Shenzhen, ChinaDepartment of Neurology, People's Hospital of Tibet Autonomous Region, Lhasa, ChinaDepartment of Psychiatry, Peking University Sixth Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Second Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Neurology, Peking University First Hospital, Peking University, Beijing, ChinaIntroductionIn China, the increasing number of people with Alzheimer's disease (AD) poses a great challenge to families and the country. Economic and cultural differences cause a urban-rural gap in medical resources. This multicenter survey aimed to investigate the real-world practice of disease treatment among people with AD.MethodsPeople with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for their treatment experience. Logistic regression was used to explore the factors that influence medication adherence in all areas, urban areas, and rural areas.ResultsIn this survey, 1,427 participants came from urban areas, and 539 participants came from rural areas. Patients in urban areas were older (mean age 74 vs. 70, p = 0.001), less frequently had mild AD (36.0 vs. 52.1%, p < 0.001), and more often were cared for at professional institutions (8.8 vs. 3.2%, p < 0.001). In terms of pharmacotherapy, 77.8% of people accepted taking lifelong medication, whereas 61.3% of patients insisted on taking medications. Although 72.0% of rural people believed in taking lifelong medication, only 30.0% adhered to drug use. The major factors that influenced medication adherence for all patients with AD were regional distribution (p < 0.001, OR = 6.18, 95% CI: 4.93–7.74) and family earnings (p = 0.003, OR = 1.22, 95% CI: 1.07–1.38). In rural areas, family earnings (p = 0.008, OR = 1.44, 95% CI: 1.10–1.89) and severity of AD (p = 0.033, OR = 1.31, 95% CI: 1.02–1.68) were the main factors. Family earnings (p = 0.038, OR = 1.16, 95% CI: 1.01–1.34) was the only factor among urban areas. Among all non-pharmaceutical activities except for cognitive intervention, the participation rates of rural patients were significantly higher than those of urban patients (p < 0.05).ConclusionAlthough national progress has been made in the public awareness of disease treatment, adequate diagnosis and medication adherence need to be prompted, especially in rural areas. Furthermore, lifelong treatment should be improved based on regional characteristics through the joint efforts of the government, health workers, and social volunteers.https://www.frontiersin.org/articles/10.3389/fneur.2022.996093/fulldementiaAlzheimer'streatmentmedication adherenceregional difference |
| spellingShingle | Bei Li Dejun Liu Qiaoqin Wan Can Sheng Xiting Wang Fangda Leng Qing Peng Ting Wang Ailian Du Feiqi Zhu Dunzhu Mima Huali Wang Hengge Xie Zhaoxia Wang Haiqiang Jin Yongan Sun Differences in treatment for Alzheimer's disease between urban and rural areas in China Frontiers in Neurology dementia Alzheimer's treatment medication adherence regional difference |
| title | Differences in treatment for Alzheimer's disease between urban and rural areas in China |
| title_full | Differences in treatment for Alzheimer's disease between urban and rural areas in China |
| title_fullStr | Differences in treatment for Alzheimer's disease between urban and rural areas in China |
| title_full_unstemmed | Differences in treatment for Alzheimer's disease between urban and rural areas in China |
| title_short | Differences in treatment for Alzheimer's disease between urban and rural areas in China |
| title_sort | differences in treatment for alzheimer s disease between urban and rural areas in china |
| topic | dementia Alzheimer's treatment medication adherence regional difference |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.996093/full |
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