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Alzheimer's Disease: Differences of Transdermal versus Oral Treatment on Caregiving Time

BACKGROUND: Data on indirect effects of dementia treatment on caregiver burden obtained from naturalistic studies are still lacking. We explored differences between patients with oral and transdermal application of acetylcholine esterase inhibitors regarding caregiver's time burden and psychopa...

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Detalles Bibliográficos
Autores principales: Riedel, O., Emmrich, A., Klotsche, J., Dodel, R., Förstl, H., Maier, W., Reichmann, H., Wittchen, H.-U.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522452/
https://www.ncbi.nlm.nih.gov/pubmed/23277781
http://dx.doi.org/10.1159/000342929
Descripción
Sumario:BACKGROUND: Data on indirect effects of dementia treatment on caregiver burden obtained from naturalistic studies are still lacking. We explored differences between patients with oral and transdermal application of acetylcholine esterase inhibitors regarding caregiver's time burden and psychopathology. METHODS: A cross-sectional naturalistic cohort study of 403 patients in outpatient care with three treatment groups (none, oral, and transdermal) was conducted. Assessments included a standardized clinical burden questionnaire and a standardized caregiver interview. RESULTS: Any treatment was associated with lower burden in most measures. Transdermal treatment was superior regarding (1) administration time (p < 0.001); (2) rates of administration problems (p = 0.031); (3) burden in activities of daily living (p = 0.008), and (4) caregiver anxiety (OR 0.25; 95% CI 0.05–0.99). Caregivers did not report better quality of life regarding mental/physical health. Physicians’ and caregivers’ ratings of patients’ improvements were not associated (κ = 0.01–0.06). CONCLUSIONS: Benefits associated with transdermal treatment do not translate into a better ‘generic quality of life’ of the caregiver. The substantially different perceptions of patients’ improvements need to be considered in future studies.