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Adherence, persistence and continuation with cholinesterase inhibitors in Alzheimer's disease
David G Le Couteur1, Maxine Robinson, Ann Leverton
1Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital, Sydney, New South Wales, Australia. david.lecouteur@sydney.edu.au
Aim:
To determine adherence, persistence and continuation beyond 6 months with cholinesterase inhibitors in Australians with Alzheimer's disease.
Methods:
Adherence and persistence with cholinesterase inhibitors were assessed by data linkage using the Pharmaceutical Benefits Scheme (PBS) Authority database and other health databases.
Results:
Over 18 000 people commenced cholinesterase inhibitors during 2004. Adherence was 79.4% while the medication possession ratio was 0.88. Some 70.3% of people filled all six scripts for the initial trial period of therapy. Some 57.3% of evaluable patients accessed funding beyond six prescriptions, indicating that their clinicians had declared that there was a two-point or more greater improvement in the Mini-Mental State Examination. Despite the high rate of continuation beyond 6 months, the rates of institutionalisation and death were no different to those reported in clinical trials.
Conclusions:
Persistence and adherence with cholinesterase inhibitors was reasonable once treatment was established. There was an unexpectedly high continuation rate beyond six prescriptions.
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