Treatment satisfaction is associated with improved quality of life in patients treated with inhaled treprostinil for pulmonary arterial hypertension

Abstract

BackgroundPatient treatment satisfaction is likely to be a highly relevant outcome measure in pulmonary arterial hypertension (PAH), a condition for which the benefits of treatment must be weighed against frequent, undesirable side effects, inconvenience, and complications associated with therapy. In this study, we sought to evaluate the psychometric properties of a patient-reported treatment satisfaction measure and its relationship to quality of life (QoL) among patients transitioning from inhaled iloprost (iILO) to inhaled treprostinil (iTRE).MethodsWe studied treatment satisfaction among 66 subjects with PAH in a single-arm, open-label, multi-center trial of iTRE following transition from iILO. Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM, version 1.4) administered to subjects immediately before and 12 weeks after transition of inhaled therapy. The TSQM is comprised of 4 domains: effectiveness, side effects, convenience, and global satisfaction. Scores range from 0 to 100 with higher scores indicating greater satisfaction. Six-minute walk distance (6MWD), functional class, adverse events, drug administration time, and PAH-specific QoL (CAMPHOR) were concurrently assessed.ResultsDomains of the TSQM demonstrated evidence of strong internal consistency at baseline and at 12 weeks (Cronbach α = 0.88-0.93). Transition from iILO to iTRE was associated with an improvement in 3 of 4 TSQM domains: effectiveness (+20 ± 21, p < 0.0001), side effects (0 ± 22, p = 0.97), convenience (+39 ± 26, p < 0.0001), and global satisfaction (+20 ± 24, p = 0.0005). Change in effectiveness scores correlated with change in 6MWD (r = 0.43, p = 0.0004) and side effects scores at 12 weeks correlated inversely with number of severity-weighted treatment-emergent adverse events (r = −0.44, p = 0.0002). In multiple regression models adjusted for baseline characteristics, changes in effectiveness and convenience satisfaction scores were significantly associated with improvement in PAH-specific QoL (p = 0.002 and p = 0.01).ConclusionsThe TSQM demonstrated acceptable performance characteristics in patients with PAH. Changes in treatment satisfaction resulting from transitioning from iILO to iTRE were associated with improvements in PAH-specific QoL.

Sex Differences in Response to Tadalafil in Pulmonary Arterial Hypertension

“…Newer therapies, directed at reducing pulmonary vascular load, have been shown to improve symptoms, quality of life, functional capacity, and, in the case of IV epoprostenol, survival. [2][3][4][5][6][7][8][9][10][11] However, PAH remains a disease without a cure in the absence of lung transplantation.…”

An evaluation of overall effectiveness and treatment satisfaction with intravenous immunoglobulin among patients with immune thrombocytopenia

“…For example, in patients with pulmonary arterial hypertension, improved scores in the effectiveness and convenience domains of the TSQM were associated with improved quality of life. 29 Improved satisfaction with treatment (as measured by the TSQM) has been correlated with medication adherence, 22,25,26,37,38 which can lead to better health outcomes and further enhancement of quality of life. 39 A strength of this study was the use of a previously validated treatment satisfaction tool that has repeatedly demonstrated good internal consistency and validity.…”

“…Previously, investigators have used the TSQM to evaluate a number of medications including subcutaneously injected and topical treatments for patients with psoriasis; [16][17][18] oral medications for patients with schizophrenia, 19 type II diabetes, 20-22 glomerulosclerosis, 23 osteoarthritis, 24 postmenopausal osteoporosis, 25 epilepsy, 26 and hypertension; 27 and inhaled medications for patients with cystic fibrosis 28 and pulmonary arterial hypertension, 29 among others. [30][31][32] Additionally, only two studies have been conducted assessing the treatment satisfaction in an IV administered medication (epoprostenol, indicated for patients with pulmonary arterial hypertension).…”

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

“…Higher levels of satisfaction with treatment impacts decisions made about health-related behaviors, improves motivation to adhere to recommended treatment (35–37) , and improves quality of life in certain chronic conditions (35) . Similarly, higher levels of self-efficacy, a construct with similarities to confidence, have been associated with better self-management behaviors such as medication adherence in hypertension (38, 39) and diabetes outcomes (40) .…”