title: Application and maintenance habits do make a difference in adhesion of Alora transdermal systems.
abstract: OBJECTIVE
  To explore and evaluate Alora placebo patch application and maintenance habits of women in order to identify the factors that influence adhesion success.
  
  
  METHODS
  This single-center, open-label, placebo, randomized, multiple-application, parallel-group study involved 99 healthy naïve users of transdermal patches. Participants applied and wore an Alora placebo patch for ten consecutive applications of approximately 3.5 days each and evaluated adhesion of the patches twice-daily. Three subgroups comprising participants achieving low, moderate or high adhesion success took part in focus groups to discuss their wear habits, practices and attitudes regarding transdermal patches.
  
  
  RESULTS
  There was a significant behavioral component involved in patch adhesion. The habits, practices and attitudes of high achievers were clearly different from the other two subgroups. The three most important issues identified to improve adhesion were: mastering the removal of the patch liner, identifying the best site of application, and developing and implementing techniques to maintain patch adhesion. The Alora placebo patch was well tolerated throughout the study.
  
  
  CONCLUSIONS
  The data showed that there is a learning curve involved in achieving maximal adhesion with a transdermal patch. During the study, a novel patch application method ('press, fold and slide') was demonstrated for the participants. This method was very well received by all participants and was more easily executed than the previous method. An adaptation of this method was incorporated into the Alora patient information leaflet, together with several other changes to help improve adhesion success.
authors.affiliation: Procter & Gamble Pharmaceuticals, Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH, USA. gomez.el@pg.com
authors.forename: E
authors.initials: E
authors.lastname: Gomez-Panzani
authors.forename: M B
authors.initials: MB
authors.lastname: Williams
authors.forename: J T
authors.initials: JT
authors.lastname: Kuznicki
authors.forename: W R
authors.initials: WR
authors.lastname: Myers
authors.forename: S A
authors.initials: SA
authors.lastname: Zoller
authors.forename: C A
authors.initials: CA
authors.lastname: Bixler
authors.forename: L C
authors.initials: LC
authors.lastname: Winkler
mesh_terms: D000268:Adhesiveness; D000279:Administration, Cutaneous; D000368:Aged; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic
chemical_list: D004958:Estradiol