Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan 

Tzu-Hsien Lai,1,2,* Wen-Fu Wang,3,* Bak-Sau Yip,4 Yu-Wan Yang,5 Giia-Sheun Peng,6 Shih-Jei Tsai,7,8 Yi-Chu Liao,9 Ming-Chyi Pai10,111Section of Neurology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, 2Department of Neurology, National Yang-Ming University School of Medicine, Taipei, 3Department of Neurology, Changhua Christian Hospital, Changhua, 4Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, 5Department of Neurology, China Medical University Hospital, Taichung, 6Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 7Department of Neurology, Chung Shan Medical University Hospital, Taichung, 8School of Medicine, Chung Shan Medical University, Taichung, 9Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 10Division of Behavioral Neurology, Department of Neurology, 11Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan *These authors contributed equally to this workPurpose: Among the medications approved for Alzheimer’s disease (AD), rivastigmine is the only one available as transdermal patch. The aim of this study was to evaluate compliance and caregivers’ preference with oral and transdermal (rivastigmine) monotherapy in patients with mild-to-moderate AD from Taiwan.Methods: Real-world Evaluation of Compliance And Preference in Alzheimer’s disease treatment (RECAP) in Taiwan was a prospective, noninterventional, observational study with a 24-week (±8weeks) observational period for each participant. Eligible patients were grouped into one of the two treatment cohorts based on the baseline AD therapy: oral (donepezil, galantamine, rivastigmine, or memantine) or transdermal (rivastigmine patch). The primary end points were caregiver preference and caregiver assessment of patients’ compliance to the current medication (oral or transdermal medication) at Week 24 (end of the study). Safety was assessed by recording any adverse events.Results: A total of 301 patients (age: 77.6±7.19years) were enrolled from nine centers in Taiwan, of whom 138 (45.8%) patients were in the transdermal monotherapy cohort. Caregivers of patients who were exposed to both forms of therapies demonstrated a higher preference for transdermal rivastigmine monotherapy than the oral monotherapy (82.4% [n=61] versus 17.6% [n=13], P