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Current Alzheimer Research


ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

Real-world Utilisation of the Rivastigmine Transdermal Patches Accompanying the Use of Risk Minimisation Tools in Patients with Dementia

Author(s): Fritjof Reinhardt, Nikolaos Scarmeas, Rajesh Karan, Uday K. Veldandi, Sunil Modali*, Krishna Duvvuri and Rashid K. Pathan

Volume 18, Issue 4, 2021

Published on: 08 September, 2021

Page: [273 - 282] Pages: 10

DOI: 10.2174/1567205018666210716120540

open access plus


Background: Transdermal patches are convenient to use, especially in Rotkreuz ZG Rotkreuz ZG patients with Alzheimer’s disease (AD)-associated dementia. However, various identified risks of errors in administering the patches cannot be disregarded. Patient Reminder Cards (PRCs, included a Medication record sheet [MRS]) have been recently introduced as a risk minimisation tool to prevent incorrect patch use (IU).

Objectives: This study aimed to assess the effectiveness of PRCs to prevent IU and to investigate the dose titration pattern of rivastigmine patches in a real-world setting.

Methods: This multinational, observational, 11-month study included patients with AD currently using rivastigmine patches (4.6 mg/day, 9.5 mg/day, 13.3 mg/day) accompanied by a caregiver. Study outcomes were IU, including multiple patch use (MPU), incorrect patch placement, other IUs, perceived usefulness of the PRCs, and titration patterns of the patches.

Results: Of the total 614 patients included, most were aged ≥ 65 years and had mild-to-moderate AD. Before and during the study, 27.7% and 18.0% of patients reported IU, respectively. Most patients used MRS, and 73.5% rated it ‘helpful’ and reported lower rates of IU than those who reported it ‘not helpful’ (13.9%-16.5% vs. 20.2%). Overall, 141 patients had dose titrations, with 75.8% being up-titrated from 4.6 mg/day to 9.5 mg/day after a mean duration of 58 days. Safety findings were consistent with the established profile for the rivastigmine patch.

Conclusion: PRC was effective as a risk minimisation tool in limiting the inappropriate use of rivastigmine patches. The majority of patients requiring dose-change were up-titrated to 9.5 mg/day patches.

Keywords: Rivastigmine patch, inappropriate medication use, multiple patch use, Alzheimer’s dementia, neurodegenerative conditions, corticobasal syndrome.

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