Global Peginterferon Beta-1a Tolerability Management Best Practices: A Nurse-Focused Delphi Approach

Abstract

Introduction: Injection site reactions (ISRs) and flu-like symptoms (FLS) are common in patients with relapsing forms of multiple sclerosis (MS) treated with peginterferon beta-1a. The purpose of this Delphi analysis was to explore peginterferon beta-1a discontinuation rates across MS treatment centers, to obtain consensus on effective mitigation and management strategies for ISRs and FLS, and to identify areas where additional training and education for nurses and patients could improve treatment outcomes. Methods: In this modified Delphi process, an international steering committee of eight MS-certified nurses developed two rounds of surveys, which were completed by 262 and 188 MS nurses, respectively, representing nine countries. Results: On average, nurses reported that 25% and 30% of patients treated with peginterferon beta-1a experienced ISRs and FLS, respectively. Discontinuation due to severe ISRs or FLS was most common in the first 6 months of treatment, yet follow-up visits typically took place 6 months after peginterferon beta-1a initiation. Preferred management strategies for ISRs included nonsteroidal anti-inflammatory drugs and rotation of the injection site, whereas preferred management strategies for FLS included acetaminophen/paracetamol and hydration/ nutrition. Most nurses (77%) agreed that additional education and training on ISR and FLS management would bolster their confidence in treating patients with these symptoms. Conclusion: Delphi respondents reached consensus on ISR and FLS management strategies, which can help to inform treatment decisions. The results of this global Delphi analysis indicate that management of ISRs and FLS could be Sarah White and Colleen Harris are co-first authors.

Preferences Toward Attributes of Disease-Modifying Therapies: The Role of Nurses in Multiple Sclerosis Care

“…18 There are very few studies of therapeutic goals aimed at understanding the perspective of nurses caring for MS patients, and they are mainly oriented toward their perception of tolerability of different drugs and advantages of autoinjectors. [30][31][32] Péloquin et al 8 investigated knowledge and attitudes regarding MS care among 135 nurses from France, Germany, Italy, Spain, Canada, United States, and the United Kingdom. Participants reported knowledge gaps on new DMTs available (51%), treatment sequencing (46%), and detection of treatment failure (52%).…”