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From the Hospital de la Sta Creu i Sant Pau, Barcelona, Spain (Prof. Blesa), Wolfson Centre for Age-related Diseases, King’s College, London, United Kingdom (Prof. Ballard), CHU Pellegrin, Bordeaux-Cx, France (Prof. Orgogozo), and Novartis Pharmaceuticals Corporation, East Hanover, New Jersey (Drs. Lane and Thomas).
Address correspondence and reprint requests to Prof. Rafael Blesa, Department of Neurology, Hospital Sta. Creu i Sant Pau, Avda. Pare Claret 167, 08025 Barcelona, Spain rblesa{at}hsp.santpau.es
Alzheimer disease (AD) has a significant impact on caregivers. Administering and managing medications is one of their many daily tasks. More effective modes of drug administration may benefit patient and caregiver, and may improve compliance. A prospective outcome of the IDEAL (Investigation of TransDermal Exelon in ALzheimer’s disease) trial was to evaluate caregiver preference for rivastigmine patches compared with capsules. The 24-week, randomized, double-blind, double-dummy, placebo- and active-controlled IDEAL trial investigated once-daily rivastigmine patches vs twice-daily capsules in moderate AD patients. Caregivers rated patch adhesion throughout. The AD Caregiver Preference Questionnaire (ADCPQ) assessed patch vs capsule from caregivers’ perspective, based on expectations, preferences, and satisfaction with treatment. A total of 1,059 caregivers completed the ADCPQ while their respective patients were on study drug. More than 70% of caregivers preferred the patch to capsules overall. The patch was preferred to capsules with respect to ease of use (p < 0.0001) and ease of following the schedule (p < 0.0001). Caregivers indicated greater satisfaction overall (p < 0.0001) and less interference with daily life (p < 0.01) with the patch vs capsules. The preference substudy of the IDEAL trial demonstrated that caregivers of AD patients preferred patches to capsules for drug delivery. Preference for the patch may indicate reduced caregiver stress, substantiated by greater satisfaction and less interference with daily life. These benefits may lead to improved compliance.
Disclosure: Prof. Blesa and Prof. Orgogozo have received personal honoraria and grant support from the sponsor during their careers. Prof. Ballard has received grant support from the sponsor during his career. Dr. Lane and Dr. Thomas are employees of the sponsor and have equity or ownership interest. This supplement has been made possible by an educational grant by Novartis Pharma AG, Basel, Switzerland.
Neurology® supplements are not peer-reviewed. Information contained in Neurology® supplements represents the opinions of the authors and is not endorsed by nor does it reflect the views of the American Academy of Neurology, Editorial Board, Editor-in-Chief, or Associate Editors of Neurology®.
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  W. Oertel, J. S. Ross, K. Eggert, and G. Adler Rationale for transdermal drug administration in Alzheimer disease Neurology, July 24, 2007; 69(4_suppl_1): S4 - S9. [Abstract] [Full Text] [PDF]
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B. Winblad, G. Grossberg, L. Frolich, M. Farlow, S. Zechner, J. Nagel, and R. Lane IDEAL: A 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease Neurology, July 24, 2007; 69(4_suppl_1): S14 - S22. [Abstract] [Full Text] [PDF]
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