OBJECTIVES: A common adverse effect of angiotensin-converting enzyme inhibitors (ACEi) is a persistent dry cough. Physicians and pharmacists who fail to recognise dry cough to be ACEi related may prescribe cough suppressants (antitussives), instead of recommended ACEi substitution. The aim of this study was to determine the amount of antitussive treatment of ACEi-induced cough and the influence of this on therapy compliance. METHODS: Prescription data from community pharmacies between 2000 and 2012 were retrieved from the IADB.nl database in The Netherlands. A prescription sequence symmetry analysis was used to determine whether antitussive agents were prescribed more often following ACEi initiation than the other way around. Therapy compliance was assessed using the proportion of days covered (PDC) method; patients with a PDC ≥80% were considered compliant. RESULTS: A total of 1898 starters of ACEi and antitussives within a half-year time span were included. A significant excess of patients received antitussives after ACEi initiation (1,269 versus 629), yielding a sequence ratio of 2.0 (CI: 1.8 -2.2). The estimated proportion of patients with ACEi induced cough receiving antitussives decreased over time: from 20.4% in 2000-2004 to 8.0% in 2008-2012. Therapy compliance in patients receiving antitussives due to ACEi initiation was 52.4%, significantly lower than compliance in control patients, which was 75.2% (P
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