{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:30:07Z","timestamp":1790983807189,"version":"4.1.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007033","name":"Eisai Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The South Korean government has been actively involved in plans to combat dementia, implementing a series of national strategies and plans since 2008. In July 2014, eligibility for mandatory long-term care insurance (LTCI) was extended to people with dementia enabling access to appropriate long-term care including the cognitive function training program and home nursing service. This study aimed to investigate changes in treatment patterns for Alzheimer\u2019s disease (AD) between July 2011 and June 2017 which spanned the 2014 revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, retrospective, observational study of patients with newly diagnosed AD analyzed electronic medical records from 17 general hospitals across South Korea. Based on their time of AD diagnosis, subjects were categorized into Cohort 1 (1 July 2011 to 30 June 2014) and Cohort 2 (1 July 2014 to 30 June 2017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Subjects (\n                      <jats:italic>N<\/jats:italic>\n                      =3,997) divided into Cohorts 1 (\n                      <jats:italic>n<\/jats:italic>\n                      =1,998) and 2 (\n                      <jats:italic>n<\/jats:italic>\n                      =1,999), were mostly female (66.4%) with a mean age of 84.4 years. Cohort 1 subjects were significantly older (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and had a lower number of comorbidities (\n                      <jats:italic>P<\/jats:italic>\n                      =0.002) compared with Cohort 2. Mean Mini-Mental State Examination (MMSE) scores in Cohorts 1 and 2 at the time of AD diagnosis or start of initial treatment were 16.9 and 17.1, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      =0.2790). At 1 year, mean MMSE scores in Cohorts 1 and 2 increased to 17.9 and 17.4, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      =0.1524). Donepezil was the most frequently administered medication overall (75.0%), with comparable rates between cohorts. Rates of medication persistence were \u226598% for acetylcholinesterase inhibitor or memantine therapy. Discontinuation and switch treatment rates were significantly lower (49.7%\n                      <jats:italic>vs.<\/jats:italic>\n                      58.0%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001), and mean duration of initial treatment significantly longer, in Cohort 2\n                      <jats:italic>vs.<\/jats:italic>\n                      1 (349.3\n                      <jats:italic>vs<\/jats:italic>\n                      . 300.2 days;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comparison of cohorts before and after revision of the national LTCI system for dementia patients found no significant difference in mean MMSE scores at the time of AD diagnosis or start of initial treatment. The reduction in the proportion of patients who discontinued or changed their initial treatment, and the significant increase in mean duration of treatment, were observed following revision of the LTCI policy which enabled increased patient access to long-term care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-024-17671-2","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T12:02:48Z","timestamp":1705060968000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Changes in dementia treatment patterns associated with changes in the National Policy in South Korea among patients with newly diagnosed Alzheimer\u2019s disease between 2011 and 2017: results from the multicenter, retrospective CAPTAIN study"],"prefix":"10.1186","volume":"24","author":[{"given":"Young Jin","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki-Youn","family":"So","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Min","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changtae","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Hoon","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Seok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heui Cheun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehyung","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Seok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Ju","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JinRan","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoona","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-6009","authenticated-orcid":false,"given":"Jun Hong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"17671_CR1","unstructured":"Alzheimer's Disease International. 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A complete list of all study sites and corresponding IRBs is provided in Supplementary Table\n                      \n                      . The following IRBs reviewed and approved the study protocol and waived the need for informed consent: Sungae Hospital IRB, Gwangju Veterans Hospital IRB, The Public Institutional Review Board (Public IRB), Daegu Fatima Hospital IRB, Daejeon St. Mary's Hospital IRB, Seoul Metropolitan Government-Seoul National University Boramae Medical Center IRB, Busan St. Mary's Hospital IRB, Andong Medical Group Hospital IRB, Jeju National University Hospital IRB, Veterans Healthcare Medical Center IRB, Changwon Fatima Hospital IRB, National Health Insurance Service Ilsan Hospital IRB, BongSeng Memorial Hospital IRB. This was a retrospective observational study and because the study did not involve more than minimum risks to subjects, the need for informed consent was not required by any of the IRBs that reviewed and approved the study protocol. The study was conducted in compliance with the relevant regulations provided by the Declaration of Helsinki and International Conference for Harmonization (ICH) Good Clinical Practice guidelines. Anonymity of subjects was maintained rigorously throughout the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JinRan Kim and Yoona Lee are both employees of Eisai Korea Inc. The other authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"168"}}