title: Alzheimer's disease treatment: assessing caregiver preferences for mode of treatment delivery.
abstract: BACKGROUND
  Management of patients with Alzheimer's Disease (AD) can exert a substantial burden upon caregivers. As new modes of treatment administration are developed, it is important to assess caregiver satisfaction and preference in a standardized manner. This study describes the development of the Alzheimer's Disease Caregiver Preference Questionnaire (ADCPQ) to assess AD caregivers' satisfaction with and preference for patch or capsule treatments in AD patients.
  
  
  METHODS
  Twenty-five published articles (1987-2002) were reviewed to identify potential ADCPQ domains. Three caregiver focus groups (n=24) were conducted to develop a first draft of the questionnaire. After evaluating the acceptance of ADCPQ to caregivers through in-depth interviews (n=10), its psychometric properties were assessed using data from 986 patients enrolled in a multicenter, randomized, double-blind, four-arm, placebo- and active-controlled, 24-week trial.
  
  
  RESULTS
  Focus groups indicated that caregivers expressed dissatisfaction with current AD treatment routines including limitations related to: efficacy, administration schedule, number of pills, adherence to treatment, side effects, and taking pills. In-depth interviews with caregivers found the ADCPQ to be comprehensible with an acceptable layout. The resultant ADCPQ comprises three modules: A) baseline, 11 items assessing treatment expectations; B) week 8, 33 items on satisfaction and preferences with treatment options; C) week 24, 10 items assessing overall opinions of treatment options. Missing data per item was low (<or=0.3%) and domain internal consistency reliability was good (0.71-0.91). Preference items were also valid when evaluating concordance and discordance between convenience and satisfaction patch and capsule domain scores.
  
  
  CONCLUSIONS
  AD treatment puts a significant strain on caregivers. New modes of treatment delivery may be less burdensome to caregivers, thereby increasing satisfaction and potential treatment adherence. The ADCPQ was well accepted by AD caregivers and its domains demonstrated satisfactory psychometric properties. The ADCPQ is a useful tool to understand caregiver preferences for patch versus oral therapies in AD.
authors.affiliation: Mapi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Abetz
authors.forename: Diana
authors.initials: D
authors.lastname: Rofail
authors.forename: Polyxane
authors.initials: P
authors.lastname: Mertzanis
authors.forename: Rebecca
authors.initials: R
authors.lastname: Heelis
authors.forename: Kathleen
authors.initials: K
authors.lastname: Rosa
authors.forename: Crystal
authors.initials: C
authors.lastname: Tellefsen
authors.forename: Aude
authors.initials: A
authors.lastname: Roborel de Climens
authors.forename: Christopher
authors.initials: C
authors.lastname: McBurney
authors.forename: Simu
authors.initials: S
authors.lastname: Thomas
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D001290:Attitude; D002214:Capsules; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011594:Psychometrics; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D002214:Capsules