Exelon Follow-up

October 23rd 2007 was the first day that the Exelon transdermal patch, the first and only skin patch for the symptomatic treatment of mild to moderately severe Alzheimer's dementia, is available in the UK market. Here's some info on it from ITNews.com, no author given:

A clinical study of 1,195 people with Alzheimer's dementia demonstrated that the rivastigmine patch improves cognitive function (assessed using a tool that includes measures of orientation, memory and language), as well as a patient's ability to perform everyday activities compared to placebo. The study also showed that the 9.5mg/24h patch is as effective as the maximum titrated dose of rivastigmine oral capsules.

Applied once a day (replaced every 24 hours), the rivastigmine patch provides smooth and continuous delivery of rivastigmine through the skin, which reduces nausea and vomiting caused by peaks in medication levels when the drug is taken orally.
Dr Peter Connelly, Consultant in Old Age Psychiatry, Perth, Scotland comments, "The Exelon patch represents a valuable advance in the treatment of Alzheimer's disease. This formulation offers patients and their carers an effective, well-tolerated and convenient therapy option. I expect a significant proportion of carers will find the patch easier to use compared to the conventional formulation."

Family cargivers are the backbone of long-term care to Alzheimer's disease patients, frequently responsible for administering and managing patient medication. A survey conducted in over 1,000 caregivers showed that more than 70 per cent preferred the patch as a method of drug delivery compared to oral capsules(3). The most common reasons for preferring the patch were ease of following the schedule and ease of use.

The rivastigmine patch can be applied to the upper arm, chest or back(4). The patch may allow those caring for Alzheimer's disease patients to monitor treatment compliance because it provides visual reassurance that the medication has been taken. Compliance with prescribed medication regimens represents a challenge for most patients but may be particularly difficult for older people due to: the extent to which drug regimens interfere with daily living; lack of understanding or misinterpretation of instructions; complex and complicated drug regimens; and forgetfulness(6). 75% of older people are believed to not comply with their treatment regimens.

"Caring for a relative with Alzheimer's is very time-consuming and sometimes overwhelming. There's a lot to think about and sufferers are often on a number of medications," comments carer Lisa, who used to look after her sister at home. "People with the disease can find it difficult to take oral medication and to comply with a strict routine. A patch that provides 24 hour cover could help keep track of when medication has been taken."

COMMENTS
I'm all for anything to improve patient medication adherence. Once again my hope is that patients remember they have the patch on and rmember to change them as well. To celebrate National Caregivers Month - here's to Novartis!