The use of the occupational disruptiveness scale of the neuropsychiatric inventory-nursing home version to measure the impact of rivastigmine on the disruptive behavior of nursing home residents with Alzheimer's disease.
OBJECTIVE
The Neuropsychiatric Inventory-Nursing Home Version (NPI-NH) was used to study the impact of rivastigmine (Exelon; Novartis Pharmaceuticals Corporation, East Hanover, NJ), on occupational disruptiveness (OD), a proxy measure for professional caregiver burden.


METHODS
The study was a prospective, multicenter, open-label, single-arm trial with NH residents prescribed rivastigmine (up to 6 mg bid) for Alzheimer's disease (AD) treatment. The NPI-NH was completed by NH staff caregivers at time of initiation of treatment with rivastigmine (T1), at treatment weeks 10 to 14 (T2), at treatment weeks 24 to 28 (T3), and at treatment weeks 50 to 54 (T4).


RESULTS
Observations ranged from 173 at baseline to 73 at week 52. All but one patient had either moderate or severe dementia. Total OD score means were 4.7 +/- 6.1, 3.9 +/- 5.0, 4.19 +/- 5.6, and 2.79 +/- 2.8 at baseline, and weeks 12, 26, and 52 (T1-T4), respectively, with significant difference found between T1 and T4. Except for euphoria and disinhibition at T3 and T4, all correlations between OD scores and the domain scores of the NPI, were significant. Rivastigmine dose was an independent variable that affected OD change.


CONCLUSIONS
Treatment with rivastigmine was associated with a reduction in the self-reported professional caregiver burden, as assessed by the NPI-NH OD scale.
Hatoum
Hind T
HT
Hind T. Hatoum & Company, Chicago, IL 60647, USA. HTHatoum@sbcglobal.net
Lin
Swu-Jane
SJ
Arcona
Stephen
S
Thomas
Simu K
SK
Koumaras
Barbara
B
Mirski
Dario
D
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D000704:Analysis of Variance; D001519:Behavior / Q000187:drug effects*; D002800:Cholinesterase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009483:Neuropsychological Tests; D009735:Nursing Homes; D048448:Phenylcarbamates / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D012044:Regression Analysis; D000068836:Rivastigmine; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000188:drug therapy*; D014481:United States
D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine