Caregiver preference for rivastigmine patch relative to capsules for treatment of probable Alzheimer's disease.
BACKGROUND
Family caregivers comprise a critical component in the care of Alzheimer's disease (AD) patients. Among their many tasks, caregivers are responsible for administering and managing medications. Effective interventions incorporate the needs of both the AD patient and the caregiver, and understanding treatment preferences may maximize intervention effectiveness. Transdermal patches may offer advantages over conventional oral formulations.


METHODS
A 24-week randomized controlled trial compared the rivastigmine patch to the rivastigmine capsule and placebo in patients with probable AD. At baseline and Weeks 8 and 24, the AD Caregiver Preference Questionnaire (ADCPQ) was used to evaluate caregiver expectations, preferences and satisfaction with treatment. Double-dummy treatment blinding ensured that caregiver preference for the patch or capsule was not confounded by perceptions of efficacy or tolerability. Reasons for preference were also elicited. The analytic sample included caregivers who completed the ADCPQ at Weeks 8 and/or 24.


RESULTS
One thousand and fifty-nine caregivers completed the ADCPQ. More than 70% of caregivers preferred the rivastigmine patch to the capsule. The patch was significantly preferred to the capsule with respect to ease of following the schedule and ease of use. Caregivers indicated greater satisfaction overall, greater satisfaction with administration, and less interference with daily life with the patch versus the capsule (all p<or=0.01).


CONCLUSIONS
Caregivers of AD patients preferred the patch to the capsule for drug delivery. Preference for the rivastigmine patch could potentially lead to improved compliance and improved clinical benefits.
Winblad
Bengt
B
Karolinska Institutet Alzheimer Research Center, Huddinge, Sweden. Bengt.Winblad@ki.se
Kawata
Ariane K
AK
Beusterien
Kathleen M
KM
Thomas
Simu K
SK
Wimo
Anders
A
Lane
Roger
R
Fillit
Howard
H
Blesa
Rafael
R
D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002214:Capsules; D017028:Caregivers / Q000523:psychology*; D002755:Choice Behavior; D017281:Cost of Illness; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D048448:Phenylcarbamates / Q000008:administration & dosage* / Q000009:adverse effects; D000068836:Rivastigmine; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D002214:Capsules; D048448:Phenylcarbamates; D000068836:Rivastigmine