Sarah White1, Colleen Harris2, Michelle Allan3, Carol Chieffe4, Piet Eelen5, Claudia Röder6, Catherine Mouzawak7, Maria L Naylor8. 1. St George's University Hospitals, London, UK. 2. Foothills Medical Centre, Calgary, AB, Canada. 3. Monash Health, Clayton, VIC, Australia. 4. Allegheny Neuroscience Institute, Monroeville, PA, USA. 5. Nationaal Multiple Sclerose Centrum V.Z.W., Melsbroek, Belgium. 6. Drs A. Stockert/C. Rettenmayr, Pforzheim, Germany. 7. Réseau SEP IDF Ouest, Saint-Germain-en-Laye, France. 8. Biogen, Cambridge, MA, USA. maria.naylor@biogen.com.
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 improved with more frequent follow-up visits and individualized training and education.
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 improved with more frequent follow-up visits and individualized training and education.
Entities:
Keywords:
Delphi; Flu-like symptoms; Injection site reaction; Peginterferon beta-1a; Tolerability
Authors: Robert T Naismith; Barry Hendin; Sibyl Wray; DeRen Huang; Fiorenza Gaudenzi; Qunming Dong; Bjørn Sperling; Monica Mann; Brian Werneburg Journal: Mult Scler J Exp Transl Clin Date: 2019-01-30
Authors: Scott D Newsome; Thomas F Scott; Douglas L Arnold; Gereon Nelles; Serena Hung; Yue Cui; Shulian Shang; Maria L Naylor; Marcelo Kremenchutzky Journal: Ther Adv Neurol Disord Date: 2018-08-28 Impact factor: 6.570