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

[ Vol. 18 , Issue. 4 ]


Fritjof Reinhardt, Nikolaos Scarmeas, Rajesh Karan, Uday K. Veldandi, Sunil Modali*, Krishna Duvvuri and Rashid K. Pathan   Pages 273 - 282 ( 10 )


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.


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


Dr. Dorothea-Erxleben-Straße 2A, 01968 Senftenberg, 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Novartis Pharma AG, Rotkreuz ZG, Novartis Healthcare Pvt. Ltd., Hyderabad, Novartis Healthcare Pvt. Ltd., Hyderabad, Novartis Healthcare Pvt. Ltd., Hyderabad, Novartis Healthcare Pvt. Ltd., Hyderabad

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