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