title: Adherence, persistence and continuation with cholinesterase inhibitors in Alzheimer's disease.
abstract: OBJECTIVE
  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.
authors.affiliation: Centre for Education and Research on Ageing, University of Sydney and Concord RG Hospital, Sydney, New South Wales, Australia. david.lecouteur@sydney.edu.au
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Maxine
authors.initials: M
authors.lastname: Robinson
authors.forename: Ann
authors.initials: A
authors.lastname: Leverton
authors.forename: Helen
authors.initials: H
authors.lastname: Creasey
authors.forename: Louise
authors.initials: L
authors.lastname: Waite
authors.forename: Kerry
authors.initials: K
authors.lastname: Atkins
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McLachlan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D001315:Australia; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D009026:Mortality; D016903:Drug Monitoring
chemical_list: D002800:Cholinesterase Inhibitors