Improved patient acceptability with a transdermal drug-in-adhesive oestradiol patch

The aim of this trial was to assess the relative patient acceptability of t wo transdermal oestradiol patches used in treatment of oestrogen deficiency in postmenopausal women. Thirty-five hysterectomised postmenopausal women with no previous experienc e of transdermal oestradiol delivery systems received treatment with: eithe r once-weekly drug-in-adhesive (DIA) patches or twice-weekly reservoir patc hes for 4 weeks, and were then switched to the alternative treatment for a further 4 weeks. At the end of the study, the patients completed a question naire to assess their relative preference for a number of characteristics o f the 2 transdermal systems and, where possible, their preference for trans dermal compared with! oral hormone replacement therapy. Thirty-one patients completed the study; four withdrew during treatment wit h the reservoir patch. The DIA patch was preferred for being 'easiest to re member to apply' by 80% of patients (p < 0.01), 'easiest to open' and 'easi est to apply' by 68% (p = 0.025), and as having 'best cosmetic appearance' by 65% (p = 0.05) and 'best overall skin adhesion' by 61% (p < 0.01). While 10% of patients rated the reservoir patch as 'least irritating to the skin ' (p = 0.03), only one patient found this patch 'most comfortable to wear' (p < 0.01). The DHA patch was selected by 87% of patients as their preferre d treatment overall (p = 0.001). Ninety-one per cent of 22 responding patie nts were at least as confident of treatment with transdermal patches as wit h oral hormone replacement therapy (p = 0.006) and 74% of 27 responders pre ferred transdermal to oral treatment (p = 0.004). The DIA patch appears to be more acceptable to patients than the reservoir patch as a transdermal oestradiol delivery system for the treatment of post menopausal oestrogen deficiency. Characteristics of the DIA patch which may account for improved patient acceptance include ease of remembering once-w eekly patch application, improved cosmetic appearance and comfort, and bett er adhesion.