Reñé R, Ricart J, Hernández B
Unidad de Diagnóstico y Tratamiento de las Demencias, Servicio de Neurología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Departamento Médico, Novartis Farmacéutica, S.A., Barcelona, España.
Neurologia. 2014 Mar;29(2):86-93. doi: 10.1016/j.nrl.2013.02.012. Epub 2013 May 17.
Rivastigmine, a treatment for mild to moderate Alzheimer disease (AD), is the first cholinesterase inhibitor to be available in the transdermal format. We aim to describe user experience and satisfaction with the rivastigmine patch, as well as any clinical changes perceived in patients.
Observational, cross-sectional, multicentre study with 239 investigators and 1851 informal caregivers of patients with mild to moderate AD. Patients were treated with transdermal rivastigmine patches for ≥ 6 months and had previously received high doses of oral rivastigmine.
Mean caregiver age was 59.8±14.4 years and 70.9% were women. They spent 10.0±7.1hours per day providing care and 79.8% lived with the patient. Patch instructions were described as easy to follow by 97.1% of the caregivers and 92.1% of them rated patch application as easy or very easy. The most commonly cited disadvantage was adhesion problems (26.8%). Discontinuation of treatment was due to cutaneous reactions in most cases. Overall, 76.5% of the caregivers were satisfied or very satisfied with transdermal treatment and 77.4% considered that its interference with daily activities was minimal or null. The patch was preferred to oral treatment by 94.3% of caregivers. Clinical Global Impression of Change ratings improved according to 61.3% of the caregivers and 53% of the investigators. Few caregivers reported medication forgetfulness.
Most caregivers of patients with mild to moderate AD preferred the transdermal format of rivastigmine to the oral format. Caregivers also reported overall satisfaction, ease of use, and reduced impact on daily activities for transdermal rivastigmine format, in addition to patient improvement compared to their condition under the previous treatment.
卡巴拉汀是一种用于治疗轻至中度阿尔茨海默病（AD）的药物，是首个以透皮剂型上市的胆碱酯酶抑制剂。我们旨在描述使用卡巴拉汀贴片的用户体验和满意度，以及患者所感知到的任何临床变化。
这是一项观察性、横断面、多中心研究，涉及239名研究者和1851名轻至中度AD患者的非正式照料者。患者接受透皮卡巴拉汀贴片治疗≥6个月，且此前曾接受过高剂量的口服卡巴拉汀治疗。
照料者的平均年龄为59.8±14.4岁，70.9%为女性。他们每天花费10.0±7.1小时提供照料，79.8%与患者同住。97.1%的照料者表示贴片说明易于遵循，其中92.1%的人认为贴片的使用容易或非常容易。最常提到的缺点是粘贴问题（26.8%）。在大多数情况下，治疗中断是由于皮肤反应。总体而言，76.5%的照料者对透皮治疗感到满意或非常满意，77.4%的人认为其对日常活动的干扰最小或没有干扰。94.3%的照料者更喜欢贴片治疗而非口服治疗。61.3%的照料者和53%的研究者表示临床总体印象变化评分有所改善。很少有照料者报告用药遗忘情况。
大多数轻至中度AD患者的照料者更喜欢卡巴拉汀的透皮剂型而非口服剂型。照料者还报告了对透皮卡巴拉汀剂型的总体满意度、易用性以及对日常活动的影响较小，此外与先前治疗相比患者病情有所改善。
