Adherence, persistence and continuation with cholinesterase inhibitors in Alzheimer's disease

Authors

  • David G Le Couteur,

    Corresponding author
    1. Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital, Sydney, New South Wales; and Drug Utilisation Sub-committee, Pharmaceutical Evaluation Section, Pharmaceutical Benefits Branch, Department of Health and Ageing, Canberra, Australian Capital Territory, Australia
      Professor David G Le Couteur, Centre for Education and Research on Ageing, Concord Hospital. Email: david.lecouteur@sydney.edu.au
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  • Maxine Robinson,

    1. Drug Utilisation Sub-committee, Pharmaceutical Evaluation Section, Pharmaceutical Benefits Branch, Department of Health and Ageing, Canberra, Australian Capital Territory, Australia
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  • Ann Leverton,

    1. Drug Utilisation Sub-committee, Pharmaceutical Evaluation Section, Pharmaceutical Benefits Branch, Department of Health and Ageing, Canberra, Australian Capital Territory, Australia
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  • Helen Creasey,

    1. Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital, Sydney, New South Wales, Australia
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  • Louise Waite,

    1. Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital, Sydney, New South Wales, Australia
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  • Kerry Atkins,

    1. Drug Utilisation Sub-committee, Pharmaceutical Evaluation Section, Pharmaceutical Benefits Branch, Department of Health and Ageing, Canberra, Australian Capital Territory, Australia
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  • Andrew J McLachlan

    1. Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital; and Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Professor David G Le Couteur, Centre for Education and Research on Ageing, Concord Hospital. Email: david.lecouteur@sydney.edu.au

Abstract

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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