Optimizing treatment initiation: Effects of a patient education program about fingolimod treatment on knowledge, self-efficacy and patient satisfaction

Zimmer, Andrea; Bläuer, Cornelia; Coslovsky, Michael; Kappos, Ludwig

doi:10.1016/j.msard.2015.06.010

Cited by 15 publications

(12 citation statements)

References 21 publications

(17 reference statements)

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“…21 Bastable suggested that patient education can increase patients' satisfaction, improve service quality, reduce patients' anxiety, reduce complications, increase participation in healthcare programs, and increase patients' independence in daily activities, which is consistent with the results of the present study. 22 Furthermore, studies conducted by Nouhi AS, Pooraboly, 15 Zimmer et al, 17 and Du et al 18 achieved results that are somewhat consistent with those of the present study, which reflects patient desire to receive patient education and nursing care. Various studies on patient education have also been conducted in Iran.…”

Section: Discussionsupporting

confidence: 89%

“…In addition to providing the necessary training for nurses, patients' self-efficacy is also significantly increased commensurate with the increase in information, which increases patient satisfaction with services. 17 In a systematic study, Du et al stated that patient education programs can be useful as potentially safe methods to reduce injury caused by disease and to increase patient satisfaction with the quality of services provided. 18 Coates et al stated that patients need to be educated on activities such as sports, health, sleep, nutrition, rest, and relaxation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Patient Education Program on the Quality of Nursing Care and Inpatient Satisfaction in Surgical Wards of Selected Hospitals in Isfahan, Iran

Keifi¹,

Shahriari

Baghersad

et al. 2016

Hosp Pract Res

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Effects of Patient Education Program on the Quality of Nursing Care and Inpatient Satisfaction in Surgical Wards of Selected Hospitals in Isfahan, Iran

Keifi¹,

Shahriari

Baghersad

et al. 2016

Hosp Pract Res

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“…Participants’ characteristics have been described elsewhere, and are summarized in Table 2 . 24 Almost 80% were women (n=78). The median age was 41 (IQR 1–3 31–46) years, ranging 22–71 years.…”

Section: Resultsmentioning

confidence: 99%

Adherence to fingolimod in multiple sclerosis: an investigator-initiated, prospective, observational, single-center cohort study

Zimmer¹,

Coslovsky²,

Abraham³

et al. 2017

PPA

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ObjectivesAdherence to multiple sclerosis (MS) treatment is essential to optimize the likelihood of full treatment effect. This prospective, observational, single-center cohort study investigated adherence to fingolimod over the 2 years following treatment initiation. Two facets of adherence – implementation and persistence – were examined and compared between new and experienced users of disease-modifying treatments (DMTs).Materials and methodsImplementation rates were based on the proportion of days covered and calculated as percentages per half-yearly visits and over 2 years, captured through refill data, pill count, and self-report. Nonadherence was defined as taking less than 85.8% of prescribed pills. Implementation rates were classified as nonadherent (<85.8%), suboptimally adherent (≥85.8% but <96.2%), and optimally adherent (≥96.2%), including perfectly adherent (100%). Persistence, ie, time until discontinuation, was analyzed by Kaplan–Meier analysis. Reasons for discontinuation were recorded.ResultsThe cohort included 98 patients with relapsing MS, all of whom received a dedicated education session about their medication. Of these 80% were women, 31.6% had fingolimod as first DMT, and 68.4% had switched from other DMTs. The mean implementation rate over 2 years was 98.6% (IQR1–3 98.51%–98.7%) and did not change significantly over time; 89% of measurements were in the optimally adherent category, 45.6% in the perfectly adherent category. There was one single occurrence of nonadherence. New users of DMTs were 1.29 times more likely to be adherent than experienced users (OR 1.29, 95% CI 1.11–1.51; P<0.001), but not more persistent. Nineteen of 98 patients discontinued fingolimod.ConclusionThe very high implementation rates displayed in this sample of MS patients suggest that facilitation by health care professionals in preserving adherence behavior may be sufficient for the majority of patients. Targeted interventions should focus on patients who are nonadherent or who stop treatment without intention to reinitiate.

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“… 18 Once the decision to start fingolimod is made, an adequate observational program and structured patient education might help to enhance patient knowledge and self-efficacy and increase adherence to the therapy. 19 In this section, we will outline the criteria for appropriate patient selection for fingolimod therapy.…”

Section: Appropriate Patient Selectionmentioning

confidence: 99%

Fingolimod for multiple sclerosis and emerging indications: appropriate patient selection, safety precautions, and special considerations

Ayzenberg¹,

Hoepner²,

Kleiter³

2016

TCRM

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Fingolimod (FTY720), an immunotherapeutic drug targeting the sphingosine-1-phosphate receptor, is a widely used medication for relapsing-remitting multiple sclerosis (MS). Apart from the pivotal Phase III trials demonstrating efficacy against placebo and interferon-β-1a once weekly, sufficient clinical data are now available to assess its real-world efficacy and safety profile. Approved indications of fingolimod differ between countries. This discrepancy, to some extent, reflects the intermediate position of fingolimod in the expanding lineup of MS medications. With individualization of therapy, appropriate patient selection gets more important. We discuss various scenarios for fingolimod use in relapsing-remitting MS and their pitfalls: as first-line therapy, as escalation therapy after failure of previous immunotherapies, and as de-escalation therapy following highly potent immunotherapies. Potential side effects such as bradycardia, infections, macular edema, teratogenicity, and progressive multifocal leukoencephalopathy as well as appropriate safety precautions are outlined. Disease reactivation has been described upon fingolimod cessation; therefore, patients should be closely monitored for MS activity for several months after stopping fingolimod. Finally, we discuss preclinical and clinical data indicating neuroprotective effects of fingolimod, which might open the way to future indications such as stroke, Alzheimer’s disease, and other neurodegenerative disorders.

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Optimizing treatment initiation: Effects of a patient education program about fingolimod treatment on knowledge, self-efficacy and patient satisfaction

Cited by 15 publications

References 21 publications

Effects of Patient Education Program on the Quality of Nursing Care and Inpatient Satisfaction in Surgical Wards of Selected Hospitals in Isfahan, Iran

Effects of Patient Education Program on the Quality of Nursing Care and Inpatient Satisfaction in Surgical Wards of Selected Hospitals in Isfahan, Iran

Adherence to fingolimod in multiple sclerosis: an investigator-initiated, prospective, observational, single-center cohort study

Fingolimod for multiple sclerosis and emerging indications: appropriate patient selection, safety precautions, and special considerations

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