title: Caregivers' and physicians' attitudes to rotigotine transdermal patch versus oral Parkinson's disease medication: an observational study.
abstract: OBJECTIVE
  To provide real-world data on caregiver and physician perceptions of the advantages and disadvantages of rotigotine transdermal patch (Neupro * ) versus oral Parkinson's Disease (PD) medication.
  
  
  METHODS
  Cross-sectional, non-interventional study in routine clinical practice in Germany (NCT01330290). Patients had PD with documented need for care, and had received rotigotine transdermal patch as add-on to oral PD treatment for ≥1 month. Caregivers/nurses and physicians assessed rotigotine transdermal patch versus oral PD medications using questionnaires. Specific questions regarding the possible benefits of transdermal application were asked and comprised questions on: swallowing dysfunction, nausea/vomiting, monitoring therapy, once daily application, application independently from meals, application to sleeping patients, caregiving efforts (caregivers only) and clinical aspects (physicians only). Each question was assessed on a 5 point scale ranging from -2 (major disadvantage) to 2 (major advantage) compared with oral treatment. Primary outcomes were mean total scores of all questions for caregivers/nurses and physicians who provided responses for ≥4 questions. As there are no validated tools to assess physician/caregiver preference in the PD setting, there is no reference against which the current findings can be compared; this study serves to pilot the questionnaires.
  
  
  RESULTS
  Questionnaire responses from 128 caregivers/nurses and 41 physicians were documented for 147 patients. One hundred (68%) patients had a caregiving family member; 40 (27%) were cared for by a nurse. Mean PD duration was 8.2 (SD 6.3) years; 136 (93%) patients were taking levodopa. Mean total score of caregivers'/nurses' questionnaires was 1.32 (SD 0.67) and of physicians' questionnaires was 1.46 (0.32) indicating a perceived advantage of rotigotine transdermal patch over oral PD therapy. Mean scores for individual questions were in the range 1.03-1.54 for caregivers/nurses and 1.15-1.87 for physicians. When given a choice about rationale to prescribe, physicians cited pharmaceutical form (patch) in 139 (95%) cases and active agent (rotigotine) in 89 (61%) cases.
  
  
  CONCLUSIONS
  Caregivers/nurses and physicians perceived advantages with rotigotine transdermal patch compared to an oral PD medication as add-on therapy in patients with PD; advantages were observed in aspects of medical treatment as well as in everyday situations of caregiving of PD patients.
authors.affiliation: Hanse-Klinikum Stralsund , Stralsund , Germany.
authors.forename: Jörn Peter
authors.initials: JP
authors.lastname: Sieb
authors.forename: Peter
authors.initials: P
authors.lastname: Themann
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.forename: Thomas
authors.initials: T
authors.lastname: Lauterbach
authors.forename: Reinhard
authors.initials: R
authors.lastname: Berkels
authors.forename: Frank
authors.initials: F
authors.lastname: Grieger
authors.forename: Stefan
authors.initials: S
authors.lastname: Lorenzl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D000279:Administration, Cutaneous; D000284:Administration, Oral; D017028:Caregivers / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D005858:Germany; D007980:Levodopa / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy; D010820:Physicians / Q000706:statistics & numerical data; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D013764:Tetrahydronaphthalenes / Q000008:administration & dosage / Q000627:therapeutic use; D013876:Thiophenes / Q000008:administration & dosage / Q000627:therapeutic use; D057968:Transdermal Patch
chemical_list: D018491:Dopamine Agonists; D007980:Levodopa; C047508:rotigotine; D013764:Tetrahydronaphthalenes; D013876:Thiophenes
keywords: Caregivers; Dopamine agonists; Parkinson’s disease; Rotigotine; Transdermal patch; Treatment preference