Cholinesterase inhibitors and Alzheimer’s disease: Patient, carer and professional factors influencing the use of drugs for Alzheimer’s disease in the United Kingdom

Between 2001 and 2006 UK guidance recommended that people with mild to moderate Alzheimer’s disease were eligible for treatment with donepezil, rivastigmine and galanatamine on the National Health Service (NHS). However, there was considerable variation in uptake of and access to treatment. This qualitative study aimed to understand which factors influence decisions to initiate, continue and discontinue treatment with the drugs. The views and experiences of 12 older people referred for memory problems or receiving treatment, 11 family carers and 16 health and social care professionals were obtained using a combination of semi-structured interviews and focus groups. Four factors outside UK guidance and prescribing budgets influence decisions to utilize the drug treatments, namely: perceptions of treatment availability and effectiveness; resource capacity; carer perceived benefits; and professional ethics. Unequal access to treatment and ethical concerns remain key issues.