Adherence to subcutaneous interferon beta-1a treatment using an electronic injection device: a prospective open-label Scandinavian noninterventional study (the ScanSmart study)

Pedersen, Elisabeth; Stenager, Egon; Vadgaard, J. L.; Mb, Jensen; Schmid, Roman; Meland, Nils; Magnussen, Gry Irene; Frederiksen, Jette Lautrup

doi:10.2147/ppa.s154417

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…Adherence of about 93% is in agreement with previously reported adherence rates to subcutaneous interferon beta therapy >90% ( 23 – 25 ) with a higher adherence of Peg IFN beta-1a compared with other subcutaneous interferons ( 26 ). However, the relatively small sample size and the short follow-up are likely to affect the comparison with data from other IFN-beta studies with longer duration and more participants.…”

Section: Discussionsupporting

confidence: 91%

Multicenter Interventional Phase IV Study for the Assessment of the Effects on Patient's Satisfaction of Peg IFN Beta-1a (Pre-filled Pen) in Subjects With Relapsing–Remitting Multiple Sclerosis Unsatisfied With Other Injectable Subcutaneous Interferons (PLATINUM Study)

et al. 2021

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Subcutaneous (SC) interferons beta (IFN-beta) are effective therapies for the treatment of relapsing–remitting multiple sclerosis (RRMS). Factors such as dosing schedule, needle intolerance/fatigue, and side effects may impact patient satisfaction with treatment. Improvement of patient satisfaction may increase the adherence to treatment and the patient quality of life. This study was aimed at evaluating the impact of switching to “Peginterferon beta-1a (Peg-IFN beta-1a)” in patients with RRMS unsatisfied with other SC interferons. The multicenter, open-label, phase IV PLATINUM study was conducted in 32 Italian centers. The primary endpoint was changes from baseline in the score of a convenience satisfaction domain of the TSQM-9 questionnaire at 12 weeks. The secondary endpoints were patients' global satisfaction, short-term adherence to treatment, satisfaction with the injection system, effect on fatigue, disease activity, and patient inability score. A total of 193 patients were enrolled and 166 (86%) completed the study, receiving Peg-IFN beta-1a for 24 weeks. Patients switching to Peg-IFN beta-1a from other SC interferons reported a significant improvement (p < 0.001) of Convenience Score and all other scores of the TSQM-9 questionnaire at 12 and 24 weeks (p < 0.001). Peg IFN beta-1a attained very high adherence to the treatment (92 and 86% at 12 and 24 weeks, respectively) with a stable annualized relapse rate (ARR). At 24 weeks, 94% of the participants were relapse free. Adverse events (AEs), recorded on 82 patients (42%), were mild or moderate. The most common AE was flu-like syndrome (29.2%). Patients switching from SC IFN beta therapy to Peg IFN beta-1a showed high treatment satisfaction with a positive safety profile, comparable with that of other currently approved first-line injectable SC interferons. This study suggests that Peg IFN beta-1a might represent a treatment choice to improve adherence in RRMS patients unsatisfied with other SC interferons.

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Section: Discussionsupporting

confidence: 91%

Multicenter Interventional Phase IV Study for the Assessment of the Effects on Patient's Satisfaction of Peg IFN Beta-1a (Pre-filled Pen) in Subjects With Relapsing–Remitting Multiple Sclerosis Unsatisfied With Other Injectable Subcutaneous Interferons (PLATINUM Study)

et al. 2021

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“…A number of smaller uncontrolled trials with follow-up periods between 12 weeks and 1.5 years revealed high adherence of ≥80%-90%. [21][22][23][24][25][26][27] Lugaresi et al 28,29 found a decrease in adherence (among completers) from 100% through week 4 to 99.1% in weeks 5-8, to 89.0% in weeks 9-12. After a long-term follow-up of 20.5 months, overall adherence was further decreased to 79.8%.…”

Section: Rebismart ®mentioning

confidence: 99%

<p>Connected drug delivery devices to complement drug treatments: potential to facilitate disease management in home setting</p>

Bittner

Chiesi

Kharawala³

et al. 2019

MDER

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Connected drug delivery devices are increasingly being developed to support patient supervision and counseling in home setting. Features may include dosing reminders, adherence trackers, tools for patient education, and patient diaries to collect patient-reported outcomes, as well as monitoring tools with interfaces between patients and health care professionals (HCPs). Five connected devices have been selected as the basis for a review of the clinical evidence concerning the impact of electronic tools on treatment adherence and efficacy outcomes. Disease areas covered include multiple sclerosis, diabetes, hypertension, liver and renal transplant recipients, tuberculosis, hepatitis C, clinically isolated syndrome, asthma, and COPD. From studies comparing the use of electronic feedback tools to standard of care, there is an initial evidence for a higher adherence to treatment and better outcomes among patients who use the electronic tools. To substantiate the assumption that connected devices can improve adherence in an outpatient setting over a prolonged period of time, further data from controlled randomized studies are required. Key barriers to the broader adoption of connected devices include data privacy laws that may prevent data sharing with HCPs in some countries, as well as the need to demonstrate that the tools are consistently used and generate a high-quality and reproducible database. If these challenges can be addressed in a way that is agreeable to all stakeholders, it is expected that the future value of connected devices will be to 1) facilitate and improve patient involvement in disease management in a flexible care setting, 2) enable early treatment decisions, and 3) complement value-based reimbursement models.

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“…For two autoinjector studies, reported adherence was 97.0% and 98.0%. For oral DMTs, MPR adherence (N = 5) ranged between 68.0% and 92.0%, PDC adherence (N = 5) ranged between 73 discontinuation rates between oral and injectable DMTs. While previous systematic reviews have examined injectable adherence or discontinuation 8,15 or oral adherence and discontinuation rates 20,21 in isolation, these results have enabled a comparison of adherence and discontinuation between these two administration modalities.…”

Section: Adherence Ratesmentioning

confidence: 99%

Objective medication adherence and persistence in people with multiple sclerosis: a systematic review, meta-analysis, and meta-regression

Mardan

Hussain

Allan

et al. 2021

JMCP

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Multiple sclerosis (MS) is a chronic, neurodegenerative disease with a reported 10.4% increase in global prevalence between 1990 and 2016, to over 2.2 million cases. 1,2 While there is no cure for MS, disease-modifying therapies (DMTs), 3,4 reduce annualized relapse rates by 18.0% to 66.0% 5,6 and disability progression by 12.0% to 41.0%. 6 Optimal medication adherence is crucial to maximize drug efficacy and reduce unnecessary healthcare expenditure. However, World Health Organization 7 data estimates approxmimately 50% of people with chronic diseases experience suboptimal medication adherence. Medication adherence in MS is no exception. Adherence rates for selfinjectable DMTs are reported as between 41% to 88% across varying measurement types, 8 and between 30% to 60% of people with MS discontinue self-injectable DMTs within two years. [9][10][11] The introduction of oral DMTs has not resolved the problem. A study assessing one-year adherence and persistence to oral DMTs-fingolimod (FTY), teriflunomide (TFN), and dimethyl fumarate (DMF)-reported that the adherence rate, measured by proportion of days covered (PDC), was less than 80% in 24.6% to 46.9% of participants with discontinuation rates between 25.6% to 50.3%. 12 Studies consistently showed an increased likelihood of suboptimal medication adherence or discontinuation with increasing treatment durations. [13][14][15] Medication adherence is "The extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen." 16 Persistence is "The duration of time from initiation to discontinuation of therapy." 16 Discontinuation is the cessation of therapy, which may be initiated by either the clinician or patient. 17 Suboptimal medication adherence may be intentional or unintentional. Intentional suboptimal adherence has been linked to perceived inefficacy, 18 cost, 19 and medication side effects. Side effects vary by DMT, but they may include fatigue, headache, nausea, or diarrhea. Specific to route of administration, injectable DMTs may incur injection site reactions and needle phobia. 3 Forgetting is the most common unintentional reason for suboptimal medication adherence. Factors such as physical disability, cognitive impairment, and depression-all common in MS patients-contribute to medication adherence difficulties. 3,18 Medication adherence may be assessed objectively, using, for example, pharmacy records, or via patient self-report.Two previous systematic reviews have been undertaken addressing medication adherence and persistence to selfadministered injectable DMTs in people with MS, 8,15 both of which predated studies that assessed medication adherence and persistence in oral DMTs. Two recent reviews of oral DMT adherence and discontinuation rates did not compare oral and injectable DMTs to quantify whether oral ABSTRACT BACKGROUND: Medication adherence is critical for the realization of pharmacotherapy benefits and reduced healthcare expenditure. Studies have shown up to 60% of people with Multiple sclerosis (MS) exper...

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Adherence to subcutaneous interferon beta-1a treatment using an electronic injection device: a prospective open-label Scandinavian noninterventional study (the ScanSmart study)

Cited by 10 publications

References 24 publications

Multicenter Interventional Phase IV Study for the Assessment of the Effects on Patient's Satisfaction of Peg IFN Beta-1a (Pre-filled Pen) in Subjects With Relapsing–Remitting Multiple Sclerosis Unsatisfied With Other Injectable Subcutaneous Interferons (PLATINUM Study)

Multicenter Interventional Phase IV Study for the Assessment of the Effects on Patient's Satisfaction of Peg IFN Beta-1a (Pre-filled Pen) in Subjects With Relapsing–Remitting Multiple Sclerosis Unsatisfied With Other Injectable Subcutaneous Interferons (PLATINUM Study)

<p>Connected drug delivery devices to complement drug treatments: potential to facilitate disease management in home setting</p>

Objective medication adherence and persistence in people with multiple sclerosis: a systematic review, meta-analysis, and meta-regression

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