Caregiver preference for rivastigmine patches versus capsules for the treatment of alzheimer disease

• Published in: Neurology Vol. 69; no. 4; pp. S23 - S28
• Main Authors: BLESA, Rafael, BALLARD, Clive, ORGOGOZO, Jean-Marc, LANE, Roger, THOMAS, Simu K
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 24-07-2007
• Subjects: Activities of Daily Living; Administration, Cutaneous; Aged; Aged, 80 and over; Alzheimer Disease - drug therapy; Alzheimer Disease - psychology; Biological and medical sciences; Caregivers - psychology; Cholinesterase Inhibitors - administration & dosage; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Patient Compliance - psychology; Patient Compliance - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Phenylcarbamates - administration & dosage; Rivastigmine; Surveys and Questionnaires; Nervous system diseases; Treatment; Alzheimer disease; Rivastigmine; Central nervous system disease; Caregiver; Degenerative disease; Patch; Comparative study; Cerebral disorder
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/01.wnl.0000281848.25142.11

Alzheimer disease (AD) has a significant impact on caregivers. Administering and managing medications is one of their many daily tasks. More effective modes of drug administration may benefit patient and caregiver, and may improve compliance. A prospective outcome of the IDEAL (Investigation of TransDermal Exelon in ALzheimer's disease) trial was to evaluate caregiver preference for rivastigmine patches compared with capsules. The 24-week, randomized, double-blind, double-dummy, placebo- and active-controlled IDEAL trial investigated once-daily rivastigmine patches vs twice-daily capsules in moderate AD patients. Caregivers rated patch adhesion throughout. The AD Caregiver Preference Questionnaire (ADCPQ) assessed patch vs capsule from caregivers' perspective, based on expectations, preferences, and satisfaction with treatment. A total of 1,059 caregivers completed the ADCPQ while their respective patients were on study drug. More than 70% of caregivers preferred the patch to capsules overall. The patch was preferred to capsules with respect to ease of use (p < 0.0001) and ease of following the schedule (p < 0.0001). Caregivers indicated greater satisfaction overall (p < 0.0001) and less interference with daily life (p < 0.01) with the patch vs capsules. The preference substudy of the IDEAL trial demonstrated that caregivers of AD patients preferred patches to capsules for drug delivery. Preference for the patch may indicate reduced caregiver stress, substantiated by greater satisfaction and less interference with daily life. These benefits may lead to improved compliance.