Caregivers’ and physicians’ attitudes to rotigotine transdermal patch versus oral Parkinson’s disease medication: an observational study

Abstract

Objective:To provide real-world data on caregiver and physician perceptions of the advantages and disadvantages of rotigotine transdermal patch (Neupro*) versus oral Parkinson's Disease (PD) medication. Methods:Cross-sectional, non-interventional study in routine clinical practice in Germany (NCT01330290). Patients had PD with documented need for care, and had received rotigotine transdermal patch as add-on to oral PD treatment for !1 month. Caregivers/nurses and physicians assessed rotigotine transdermal patch versus oral PD medications using questionnaires. Specific questions regarding the possible benefits of transdermal application were asked and comprised questions on: swallowing dysfunction, nausea/vomiting, monitoring therapy, once daily application, application independently from meals, application to sleeping patients, caregiving efforts (caregivers only) and clinical aspects (physicians only). Each question was assessed on a 5 point scale ranging from -2 (major disadvantage) to 2 (major advantage) compared with oral treatment. Primary outcomes were mean total scores of all questions for caregivers/nurses and physicians who provided responses for !4 questions. As there are no validated tools to assess physician/caregiver preference in the PD setting, there is no reference against which the current findings can be compared; this study serves to pilot the questionnaires. Results:Questionnaire responses from 128 caregivers/nurses and 41 physicians were documented for 147 patients. One hundred (68%) patients had a caregiving family member; 40 (27%) were cared for by a nurse. Mean PD duration was 8.2 (SD 6.3) years; 136 (93%) patients were taking levodopa. Mean total score of caregivers'/ nurses' questionnaires was 1.32 (SD 0.67) and of physicians' questionnaires was 1.46 (0.32) indicating a perceived advantage of rotigotine transdermal patch over oral PD therapy. Mean scores for individual questions were in the range 1.03-1.54 for caregivers/nurses and 1.15-1.87 for physicians. When given a choice about rationale to prescribe, physicians cited pharmaceutical form (patch) in 139 (95%) cases and active agent (rotigotine) in 89 (61%) cases. Conclusion:Caregivers/nurses and physicians perceived advantages with rotigotine transdermal patch compared to an oral PD medication as add-on therapy in patients with PD; advantages were observed in aspects of medical treatment as well as in everyday situations of caregiving of PD patients.*Neupro is a registered trade name of UCB

Critical appraisal of rotigotine transdermal system in management of Parkinson’s disease and restless legs syndrome – patient considerations

“…Physicians cited pharmaceutical form (patch) in 139 (95%) cases as a rationale to prescribe. 57 Conclusion RTG has been found to be a safe and effective treatment for PD and RLS. Because of its transdermal application, RTG provides continuous dopamine delivery and steady plasma concentrations.…”

“…Convenience of transdermal administration compared to PO, ability to use with general anesthesia, and enhanced absorption are some of the major reasons physicians and nurses prefer the use of RTG over other therapies for PD. 57 In a cross-sectional, non-interventional study in clinical practice in Germany, 100 caregivers, 40 nurses, and 41 physicians caring for 147 patients (93% taking levodopa) with PD answered questions about how RTG compares to oral PD medication in several domains, including swallowing dysfunction, nausea/vomiting, monitoring therapy, once-a-day dosing, dosing independent of meals, application of the medication to a sleeping patient, and caregiver effortsor clinical aspects. 57 The mean total score of caregivers'/nurses' questionnaires was 1.32 (SD 0.67) and of physicians' questionnaires was 1.46 (SD 0.32), indicating a perceived advantage of the RTG transdermal patch over oral PD therapy.…”

Rotigotine Transdermal Patch for Motor and Non-motor Parkinson’s Disease: A Review of 12 Years’ Clinical Experience

“…A cross-sectional, non-interventional study assessing the attitudes of caregivers/nurses (n = 128) and physicians (n = 41) to the transdermal patch showed a significant benefit in the care of patients with PD in everyday situations and when undergoing medical treatment when the rotigotine transdermal patch was an additional therapy compared with oral medication [131]. The burden on caregivers and the workload for drug management in the care of patients with PD could be reduced with the simple once-daily application of the rotigotine transdermal patch.…”

The efficacy and tolerability of rotigotine on patients with periodic limb movement in sleep: A systematic review and meta-analysis

“…However, no meta-analysis, to the best of our knowledge, aimed to assess the efficacy of rotigotine in reducing PLMI [ 30 , 36 , 37 ]. Unlike pramipexole and ropinirole, which must be taken orally, rotigotine can be administered through transdermal patches that successfully maintain stable plasma levels over the course of a day in a manner that physicians perceive to be advantageous [ 38 , 39 ]. Thus far, rotigotine has not been comprehensively reviewed to explore its role in the alleviation of PLMS.…”