Characteristics of patients with Alzheimer’s disease who switch to rivastigmine transdermal patches in routine clinical practice

Figures & data

Table 1 Sociodemographic and clinical characteristics of patients

Characteristics	Evaluable patients (n = 1022)
Age (years), mean ± SD	78.4 ± 6.62
Gender, n (%)
Male	381 (37.39)
Female	638 (62.61)
Weight (kg), mean ± SD	68.4 ± 11.08
Height (cm), mean ± SD	163.5 ± 8.82
Blood pressure (mmHg), mean ± SD
Systolic	136.34 ± 15.93
Diastolic	78.86 ± 10.68
Living situation, n (%)
Alone	95 (9.42)
Accompanied	913 (90.58)
Availability of caregiver, n (%)	1010 (99.02)
Institutionalized patients, n (%)	175 (17.17)
Time of evolution of AD (years), mean ± SD	2.46 ± 1.98
Family history of AD, n (%)	275 (27.17)
Severity of AD, n (%)
Mild (MMSE score 24–21)	400 (39.14)
Moderate (MMSE score 20–15)	457 (44.72)
Moderately severe (MMSE score 14–10)	165 (16.14)
MMSE score, median (Q1–Q3)	20 (16–22)
Concomitant diseases, n (%)	838 (82.00)
Concomitant treatments, n (%)	801 (78.38)
Previous treatments for AD, n (%)
Rivastigmine	519 (50.78)
Capsules	243 (46.82)
Oral solution	272 (52.41)
Donepezil	333 (32.58)
Donepezil ODT	153 (45.95)
Standard tablets	178 (53.45)
Galantamine	147 (14.38)
Extended release capsules	119 (80.95)
Standard tablets	19 (12.93)
Oral solution	7 (4.76)
Memantine	49 (4.79)
Doses of ChEIs (mg), mean ± SD
Oral rivastigmine	8.17 ± 3.99
Donepezil	9.12 ± 2.33
Galantamine	17.6 ± 6.17

Abbreviations: AD, Alzheimer’s disease; ChEIs, cholinesterase inhibitors; MMSE, Mini-Mental State Examination; SD, standard deviation; Q1, first quartile; Q3, third quartile; ODT, orally disintegrating tablets.

Table 2 Severity of AD depending on years of evolution and family history of the disease

	Statistic	Severity of AD (MMSE score)
		Mild (24–21)	Moderate (20–15)	Moderately severe (14–10)
Time of AD evolution (years)	n	355	415	146
	Mean (SD)	2.3 ± 2.03	2.3 ± 1.73	3.32 ± 2.27
	Median	2	2	3
	Minimum–maximum	0–15	0–11	0–15
	CI 95%	(2.09–2.51)	(2.13–2.47)	(2.95–3.69)
	ANOVA (P value)	<0.0001
Family history of AD
Yes	n (%)	109 (30.28)	120 (29.85)	46 (31.29)
No	n (%)	251 (69.72)	282 (70.15)	101 (68.71)
	Chi-squared test (P value)	0.9483

Abbreviations: AD, Alzheimer’s disease; ANOVA, analysis of variance; CI, confidence interval; MMSE, Mini-Mental State Examination; SD, standard deviation.

Table 3 Promoters and reasons of switch to rivastigmine patches

	Evaluable patients (n = 1022)
Promoter of switch, n (%)
Physician	842 (82.39)
Patient	106 (10.37)
Caregiver	217 (21.23)
Reason for switch, n (%)
Improving the ease of administration	579 (56.65)
Lack of efficacy/improving efficacy	323 (31.60)
Intolerability/improving tolerability	376 (36.79)
Poor adherence to treatment (not due to intolerability)	190 (18.59)
Physical diseases impairing administration	19 (1.86)
Rejection by the patient	79 (7.73)
Difficulty of medication management	70 (6.85)
Excessive caregiver burden	58 (5.67)

Note: Subjects were allowed to indicate several promoters and reasons.

Table 4 Results of the stepwise logistic regression analysis to find factors associated with different promoters for switch to rivastigmine patches

	Odds ratio			P value
	Point estimate	Low 95% CI	Upper 95% CI
Physician as promoter of switch
Previous treatment for AD
Donepezil versus rivastigmine	0.595	0.393	0.902	0.0145
Galantamine versus rivastigmine	1.277	0.694	2.348	0.4318
Other versus rivastigmine	1.824	0.415	8.014	0.4262
Patient as promoter of switch
MMSE score	1.163	1.078	1.255	0.0001
Number of concomitant diseases	1.438	1.146	1.805	0.0017
Number of concomitant treatments	0.661	0.528	0.828	0.0003

Abbreviations: AD, Alzheimer’s disease; CI, confidence interval; MMSE, Mini-Mental State Examination.

Table 5 Results of the stepwise logistic regression analysis to find factors associated with different reasons for switch to rivastigmine patches

	Odds ratio			P value
	Point estimate	Low 95% CI	Upper 95% CI
Reason for switch
Improving ease of administration
Previous treatment for AD
Donepezil versus rivastigmine	0.238	0.167	0.337	<0.0001
Galantamine versus rivastigmine	0.281	0.183	0.432	<0.0001
Reason for switch
Lack of efficacy
Previous treatment for AD
Donepezil versus rivastigmine	4.303	2.957	6.261	<0.0001
Galantamine versus rivastigmine	3.928	2.505	6.160	<0.0001
Reason for switch
Intolerability
Educational level of caregiver
Primary education versus no studies	1.340	0.871	2.060	0.1829
Secondary education versus no studies	1.672	1.069	2.613	0.0242
Higher education versus no studies	2.158	1.237	3.767	0.0068
Number of concomitant diseases	1.116	1.001	1.246	0.0486
Reason for switch
Poor adherence
Educational level of patient
Primary education versus no studies	0.551	0.361	0.840	0.0056
Secondary education versus no studies	0.741	0.407	1.352	0.3286
Higher education versus no studies	0.896	0.393	2.044	0.7948
Number of concomitant diseases	1.250	1.098	1.424	0.0007

Abbreviations: AD, Alzheimer’s disease; CI, confidence interval.