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.

Key words: :

• Caregivers
• Dopamine agonists
• Parkinson’s disease
• Rotigotine
• Transdermal patch
• Treatment preference

Transparency

Declaration of funding

This study was supported by UCB Pharma, Monheim am Rhein, Germany. The questionnaires were devised by the authors in association with UCB Pharma.

Declaration of financial/other relationships

J.P.S. has disclosed that he has received honoraria for lectures and for advisory efforts from Boehringer Ingelheim, Teva and UCB Pharma prior to 2012; however, since 2012 he receives no honoraria from any pharmaceutical companies. P.T. has disclosed that he has received lecture fees from Abbvie, TEVA, UCB Pharma, Orion Pharma, Novartis and Desitin. T.W. has disclosed that he has received lecture fees from Abbvie, Teva, Bayer and UCB Pharma; worked as a consultant for Archimedes and UCB Pharma; and receives a research grant from Deutsche Parkinson Vereinigung eV (dPV). S.L. has disclosed that he has received honoraria from UCB Pharma, Boehringer, Teva, Gruenenthal and Orion Pharma. T.L., R.B. and F.G. have disclosed that they are employees of UCB Pharma, Monheim am Rhein, Germany.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors acknowledge Emily Thompson PhD (Evidence Scientific Solutions, London, UK) for writing support which was funded by UCB Pharma, Brussels, Belgium, and Cédric Laloyoux PhD (Global Publications Manager, UCB Pharma, Brussels, Belgium) for publication coordination.

Previous presentation: Abstract presented at the World Parkinson Congress, 1–4 October 2013, Montreal, Canada: Sieb JP, Themann P, Warnecke T, et al. Non-interventional study of caregivers’ and physicians’ attitudes to drug administration via a transdermal patch in patients with Parkinson’s disease who require caregiver support.

Notes

*Neupro is a registered trade name of UCB Manufacturing Ireland Ltd, Shannon, Ireland

*Neupro is a registered trade name of UCB Manufacturing Ireland Ltd, Shannon, Ireland