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Masri HE, McGuire TM, Dalais C, van Driel M, Benham H, Hollingworth SA. Patient-based benefit-risk assessment of medicines: development, refinement, and validation of a content search strategy to retrieve relevant studies. J Med Libr Assoc 2022; 110:185-204. [PMID: 35440905 PMCID: PMC9014953 DOI: 10.5195/jmla.2022.1306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction: Poor indexing and inconsistent use of terms and keywords may prevent efficient retrieval of studies on the patient-based benefit-risk assessment (BRA) of medicines. We aimed to develop and validate an objectively derived content search strategy containing generic search terms that can be adapted for any search for evidence on patient-based BRA of medicines for any therapeutic area. Methods: We used a robust multistep process to develop and validate the content search strategy: (1) we developed a bank of search terms derived from screening studies on patient-based BRA of medicines in various therapeutic areas, (2) we refined the proposed content search strategy through an iterative process of testing sensitivity and precision of search terms, and (3) we validated the final search strategy in PubMed by firstly using multiple sclerosis as a case condition and secondly computing its relative performance versus a published systematic review on patient-based BRA of medicines in rheumatoid arthritis. Results: We conceptualized a final search strategy to retrieve studies on patient-based BRA containing generic search terms grouped into two domains, namely the patient and the BRA of medicines (sensitivity 84%, specificity 99.4%, precision 20.7%). The relative performance of the content search strategy was 85.7% compared with a search from a published systematic review of patient preferences in the treatment of rheumatoid arthritis. We also developed a more extended filter, with a relative performance of 93.3% when compared with a search from a published systematic review of patient preferences in lung cancer.
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Affiliation(s)
- Hiba El Masri
- , PhD Candidate, School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia
| | - Treasure M McGuire
- , Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia, Mater Pharmacy, Mater Health, Raymond Tce, South Brisbane, QLD, Australia
| | - Christine Dalais
- , University Library, The University of Queensland, Brisbane, QLD, Australia
| | - Mieke van Driel
- , Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Benham
- , Department of Rheumatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
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Wilski M, Kocur P, Górny M, Koper M, Nadolska A, Chmielewski B, Tomczak M. Perception of Multiple Sclerosis Impact and Treatment Efficacy Beliefs: Mediating Effect of Patient's Illness and Self-Appraisals. J Pain Symptom Manage 2019; 58:437-444. [PMID: 31233844 DOI: 10.1016/j.jpainsymman.2019.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 01/10/2023]
Abstract
CONTEXT Patients with multiple sclerosis (MS) experience many negative, seriously aggravating disease symptoms, and hence, research studies are utmost required to improve their coping with symptoms. Our research is an attempt to show ways to increase participation of patients with MS in the treatment and treatment planning process, as well as in managing the symptoms of the disease. OBJECTIVES To examine the relationship between perception of MS impact and treatment efficacy beliefs in patients with MS and the extent to which self and illness appraisals can be regarded as mediator variables in this relationship. METHODS The cross-sectional study included 278 MS patients who completed the Treatment Beliefs Scale, Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Brief Illness Perception Questionnaire. Demographic and clinical characteristics of the participants were collected with a self-report survey. RESULTS Illness perception and general self-efficacy mediated the relationship between perception of MS impact and treatment efficacy beliefs under the control of age and time from diagnosis. The standardized indirect effects for illness perception and general self-efficacy were -0.131 95% CI [-0.2029, -0.0739] and -0.086 95% CI [-0.1663, -0.0165], respectively. CONCLUSION Our results indicate that worse perception of physical condition in patients with MS is associated with more negative treatment efficacy beliefs, and that this association is mediated by self-efficacy and illness perception. To inhibit the increase of negative treatment efficacy beliefs, health care specialists can work on improving self-efficacy and illness appraisals.
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Affiliation(s)
- Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland.
| | - Piotr Kocur
- Department of Musculoskeletal Rehabilitation, Poznań University of Physical Education, Poznań, Poland
| | - Mirosław Górny
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Magdalena Koper
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Anna Nadolska
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Bartosz Chmielewski
- Department of Physical Education and Physiotherapy, State University of Applied Sciences, Konin, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznań University of Physical Education, Poznań, Poland
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Buesa-Estelléz A, Cano-de-la-Cuerda R, Ortiz-Gutiérrez RM, Palacios-Ceña D. The impact of pharmacological treatment on patients with multiple sclerosis. Disabil Health J 2019; 12:615-621. [PMID: 31133483 DOI: 10.1016/j.dhjo.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 05/09/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple sclerosis has considerable effects on patients' quality of life, limiting their daily activities and influencing their lifestyle. Additionally, adapting to pharmacological treatments represents a challenge for many patients. OBJECTIVE The aim of this study was to explore the views and experiences of Spanish patients with multiple sclerosis regarding their pharmacological treatment. METHODS A qualitative phenomenological study was conducted with 20 patients with Multiple Sclerosis from a hospital Neurology Unit. Data were collected through in-depth interviews and researchers' field notes. A systematic text condensation analysis was performed. The Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research guidelines were followed. RESULTS Twenty patients with Multiple Sclerosis completed the study. The mean age was 39.7 years (SD: 9,17). A thematic description of all the data collected was performed based on four descriptive themes which emerged from the analysed material: a) Undergoing the injections, b) Coping strategies, with two subthemes, resignation and integrating the treatment into their life, c) Other methods of pharmacological administration, and d) Dealing with discomfort. For patients with multiple sclerosis, their experience with pharmacological treatment is an apprenticeship which is sometimes met with resignation and discomfort. Patients must learn to take responsibility for their treatment, seeking other routes of administration, as well as integrating these changes into their daily life. CONCLUSIONS Qualitative research offers insight into the way patients with Multiple Sclerosis experience their pharmacological treatment, and may be helpful in establishing a fruitful relationship with these patients.
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Affiliation(s)
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | | | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Ernst FR, Barr P, Elmor R, Wong SL. Relapse outcomes, safety, and treatment patterns in patients diagnosed with relapsing-remitting multiple sclerosis and initiated on subcutaneous interferon β-1a or dimethyl fumarate: a real-world study. Curr Med Res Opin 2017; 33:2099-2106. [PMID: 28906152 DOI: 10.1080/03007995.2017.1380616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To estimate real-world treatment patterns, safety, and relapse outcomes of subcutaneous (sc) interferon (IFN) β-1a (Rebif) vs dimethyl fumarate (DMF; Tecfidera), to treat relapsing-remitting multiple sclerosis (RRMS). METHODS A US retrospective chart review of 450 randomly selected adults newly diagnosed with RRMS who received sc IFN β-1a (n = 143) or DMF (n = 307) was conducted. Patients were either (a) treatment-naïve, initiating first-line treatment with sc IFN β-1a or DMF, or (b) previously treated, switching to sc IFN β-1a or DMF. Two years' follow-up data were captured. Patient characteristics, persistence, and adverse events between treatment groups were compared using t-tests or Chi-square tests. Kaplan-Meier curves with log-rank tests and Cox proportional hazards models were used to compare time to, and risk of non-persistence. Annualized Relapse Rates (ARR) were calculated using a robust variance Poisson model adjusting for covariates. Propensity scores were used to address possible selection bias. RESULTS One hundred and twelve patients became non-persistent, most commonly due to an adverse event (n = 37). No difference was observed in time to overall non-persistence between sc IFN β-1a and DMF patients. Among treatment-naïve patients, those receiving DMF had 2.4-times the risk (HR = 2.439, 95% CI = 1.007-5.917, p = .0483) of experiencing a discontinuation than patients receiving sc IFN β-1a. Non-persistent patients receiving DMF had 2.3-times the risk (HR = 2.311, 95% CI = 1.350-3.958, p = .0023) of experiencing an adverse event at a given time point than patients prescribed sc IFN β-1a. No differences in relapse risk or ARR between sc IFN β-1a- and DMF-treated patients were observed. CONCLUSIONS sc IFN β-1a-treated patients had comparable persistence and relapse outcomes, and better safety outcomes vs DMF-treated patients across 2 years.
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Affiliation(s)
- Frank R Ernst
- a Health Economics and Outcomes Research , Indegene, Inc. , Kennesaw , GA , USA
| | - Peri Barr
- a Health Economics and Outcomes Research , Indegene, Inc. , Kennesaw , GA , USA
| | - Riad Elmor
- a Health Economics and Outcomes Research , Indegene, Inc. , Kennesaw , GA , USA
| | - Schiffon L Wong
- b Global Evidence & Value Development, Global Research & Development , EMD Serono, Inc. , Billerica , MA , USA
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Multiple sclerosis patients' understanding and preferences for risks and benefits of disease-modifying drugs: A systematic review. J Neurol Sci 2017; 375:107-122. [DOI: 10.1016/j.jns.2016.12.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/28/2016] [Accepted: 12/21/2016] [Indexed: 11/17/2022]
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Nicholas J, Ko JJ, Park Y, Navaratnam P, Friedman HS, Ernst FR, Herrera V. Assessment of treatment patterns associated with injectable disease-modifying therapy among relapsing-remitting multiple sclerosis patients. Mult Scler J Exp Transl Clin 2017; 3:2055217317696114. [PMID: 28607751 PMCID: PMC5459267 DOI: 10.1177/2055217317696114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/05/2017] [Indexed: 12/28/2022] Open
Abstract
Background Availability of oral disease-modifying therapy (DMT) for relapsing–remitting multiple sclerosis (RRMS) may affect injectable DMT (iDMT) treatment patterns. Objective The objective of this paper is to evaluate iDMT persistency, reasons for persistency lapses, and outcomes among newly diagnosed RRMS patients. Methods Medical records of 300 RRMS patients initiated on iDMT between 2008 and 2013 were abstracted from 18 US-based neurology clinics. Eligible patients had ≥3 visits: pre-iDMT initiation, iDMT initiation (index), and ≥1 visit within 24 months post-index. MS-related symptoms, relapses, iDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for non-persistency were tracked for 24 months. Results At 24 months, iDMT persistency was 61.0%; 28.0% of patients switched to another DMT, 8.0% discontinued, and 3.0% stopped and restarted the same iDMT. The most commonly identified reasons for non-persistency were perceived lack of efficacy (22.2%), adverse events (18.8%), and fear of needles/self-injecting (9.4%). At 24 months, 38.0% of patients had experienced a relapse and 11.0% had changes in MRI lesion counts. Patients without MS-related symptoms at index reported increases in the incidence of these symptoms at 24 months. Conclusions Non-persistency with iDMT remains an issue in the oral DMT age. Many patients still experienced relapses and disease progression, and should consider switching to more effective therapies.
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Affiliation(s)
- J Nicholas
- OhioHealth MS Center, Riverside Methodist Hospital, USA
| | | | - Y Park
- Novartis Pharmaceuticals Corporation, USA
| | | | | | | | - V Herrera
- Novartis Pharmaceuticals Corporation, USA
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Hendin B, Huang D, Wray S, Naismith RT, Rosenblatt S, Zambrano J, Werneburg B. Subcutaneous peginterferon β-1a injection-site reaction experience and mitigation: Delphi analysis of the ALLOW study. Neurodegener Dis Manag 2017; 7:39-47. [PMID: 28071330 DOI: 10.2217/nmt-2016-0032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM The objective of this Delphi analysis was to obtain consensus on injection-site reaction (ISR) experience and mitigation strategies for patients with relapsing-remitting multiple sclerosis switching from nonpegylated interferons (IFNs) to peginterferon β-1a in the ALLOW Phase IIIb trial using a three-step approach. METHODS Study investigators and coordinators from investigative sites enrolling four or more patients in ALLOW participated in three rounds of questionnaires and interviews. RESULTS Respondents (n = 37) agreed that the most common ISR, erythema, was not disruptive to daily activities. Patient education, as a conversation with a clinician about ISR potential, was recommended. CONCLUSION The consensus of Delphi respondents on ISR experience and ISR management after switching from nonpegylated IFNs to peginterferon β-1a can help inform treatment decisions and manage patient expectations.
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Affiliation(s)
- Barry Hendin
- Phoenix Neurological Associates, Phoenix, AZ, USA
| | - DeRen Huang
- Neurology & Neuroscience Associates, Akron, OH, USA
| | | | - Robert T Naismith
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
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Ziemssen T, Calabrese P, Penner IK, Apfel R. QualiCOP: real-world effectiveness, tolerability, and quality of life in patients with relapsing-remitting multiple sclerosis treated with glatiramer acetate, treatment-naïve patients, and previously treated patients. J Neurol 2016; 263:784-91. [DOI: 10.1007/s00415-016-8058-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Poor treatment adherence is common among patients with multiple sclerosis (MS). This survey evaluated neurologists' perception of treatment adherence among MS patients. MATERIALS AND METHODS This questionnaire-based survey of Belgian neurologists treating MS patients was conducted between June and July 2014. Face-to-face interviews with the neurologists were based on a semistructured questionnaire containing questions regarding the perception of the treatment-adherence level. RESULTS A total of 41 neurologists participated in the survey. Of these, 88% indicated frequent discussions about treatment adherence as beneficial for treatment efficacy. The mean time spent on the treatment-adherence discussion during the initial consultation was 11 minutes, with 24% of doctors spending 5 minutes and 24% of doctors spending 10 minutes discussing this issue. The majority of neurologists (56%) perceived the adherence level in MS as good, and 12% perceived it as excellent. The majority of neurologists (64%) indicated intolerance as a main cause of poor adherence, and all neurologists reported insufficient efficacy as a consequence of nonadherence. The importance of adherence in the neurologists' practice was evaluated on a scale of 1-10, with 1= "not very important" and 10= "very important": 44% of doctors indicated a score of 10, and the mean score was 9.0. CONCLUSION Belgian neurologists consider treatment adherence in MS as essential for the benefits of therapies. However, although neurologists are aware of the consequences of nonadherence, they generally spend limited time discussing the importance of treatment adherence with their patients.
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Affiliation(s)
- Danny Decoo
- Department of Neurology and Neurorehab, AZ Alma, Sijsele, Belgium
- Correspondence: Danny Decoo, Department of Neurology and Neurorehab, AZ Alma, Campus Sijsele, 132 Gentse Steenweg, Sijsele, Damme 8340, Belgium, Tel +32 50 728 051, Fax +32 50 728 008, Email
| | - Mathieu Vokaer
- Multiple Sclerosis Clinic, Edith Cavell Hospital, CHIREC group, Brussels, Belgium
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Lizán L, Comellas M, Paz S, Poveda JL, Meletiche DM, Polanco C. Treatment adherence and other patient-reported outcomes as cost determinants in multiple sclerosis: a review of the literature. Patient Prefer Adherence 2014; 8:1653-64. [PMID: 25525341 PMCID: PMC4262214 DOI: 10.2147/ppa.s67253] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Treatment adherence is one of the key factors for achieving optimal clinical outcomes. In order to assess costs related to adherence to, and persistence and compliance with, disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS), a narrative review of the literature was performed. Satisfaction with and preference for DMTs and their delivery devices were also assessed, as both can have an influence on patients' adherence and persistence. METHODS Electronic databases (MEDLINE, PubMed, Google Scholar, congress proceedings) were searched to identify publications analyzing MS costs related to adherence, persistence, satisfaction, and preferences for MS treatments. Bibliographic references were hand searched. English or Spanish studies published between January 2007 and January 2013 were selected. RESULTS A total of 398 titles were identified, of which 12 met the inclusion criteria. Six studies evaluated the impact of adherence, persistence, and compliance on treatment costs; four publications analyzed satisfaction with DMTs; and two assessed treatment preferences based on attributes of the delivery device. Increased adherence and persistence were associated with better clinical outcomes, leading to lower relapse risk (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.59-0.85) and a decrease in health care resource use, such as MS-related hospitalizations (OR: 0.63; 95% CI: 0.47-0.83) and emergency department visits (OR: 0.80; 95% CI: 0.60-1.07). This reduction in resource use led to a patient/year total cost reduction (excluding DMT costs) of up to 22%. CONCLUSION This review highlights the importance of ensuring adequate adherence in MS patients through treatments and devices better tailored to patients' needs that could enhance clinical outcomes and reduce MS costs. Understanding the factors underlying satisfaction and compliance with treatment and patients' preference for certain therapies could help in the development of strategies that can improve adherence.
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Affiliation(s)
| | | | | | | | | | - Carlos Polanco
- Merck S.L., Madrid, Spain
- Correspondence: Carlos Polanco, Corporate Affairs, Merck SL, María de Molina, 40, 28006 Madrid, Spain, Tel +34 917 453 158, Fax +34 917 454 444, Email
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