AB1379B-HPR PATIENT SATISFACTION IS HIGH IN PATIENTS TRAINED TO SELF-INJECT WITH A BUTTON FREE AUTO-INJECTION USING VIDEO TRAINING
Authors: Dawn Homer
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Once-weekly subcutaneous injection of methotrexate can optimize long-term treatment of rheumatic diseases such as rheumatoid arthritis.<sup>1</sup> However, available self-injection devices vary in terms of ease of use and level of operational dexterity required. <h3>Objectives</h3> This pilot study compared patient satisfaction with use of a methotrexate pre-filled, button-free, auto-injector pen (Nordic Pharma, UK) for subcutaneous injection with previous use of a button-activated pen device following the option to self-train via video. <h3>Methods</h3> Patients with rheumatoid arthritis currently administering subcutaneous methotrexate using a button-activated pen device were invited to change to a button-free auto-injector by letter. They were given the option to self-train using an online video or receive one-to-one instruction from a rheumatology nurse. Initial follow-up took place immediately after the first injection; invitation to participate in a 10-minute telephone questionnaire to evaluate their experience of using their new device took place after 3-4 weeks. Satisfaction with the device was assessed overall and according to 7 specific autoinjector attributes: ease of injection; experience of injection; comfort in hand; use with dexterity issues or during flare-ups; confidence in full dose being given; convenience of storage and disposal; and portability. <h3>Results</h3> Thirty-three patients were invited to change to an auto-injector: 22 patients responded (response rate: 64.7%), 19 of which made the switch and completed the survey. 79% of patients overall were satisfied or very satisfied with administering methotrexate using the auto-injector; 85% of patients were equally or more satisfied with the use of an auto-injector pen compared to their previous device. Patients were equally or more satisfied with the new device across all 7 autoinjector attributes: convenience of storage and disposal (100.0%), portability (100.0%); comfort in the hand (94.1%); confidence in full dose being given (88.9%); use with dexterity issues or during flare-ups (85.7%); ease of injection (82.4%); experience of injection (68.4%). Self-training via video did not negatively affect satisfaction: 83.3% of those patients confident in their ability to perform self-injection correctly after viewing the video were satisfied or very satisfied with their new autoinjector device. Three patients discontinued with the new device: one switched to oral therapy for reasons unrelated to the device; two returned to their original device. <h3>Conclusion</h3> This pilot study showed that patients were more satisfied with use of a methotrexate button-free auto-injector device than with their previous auto-injector device across all 7 user attributes and that satisfaction was maintained with use of self-training. Patient views regarding acceptability and use of auto-injection devices should be considered when making device switches based on cost and nurse resource allocation to ensure continued adherence with injected medication. <h3>References</h3> [1] Bianchi B, et al. Methotrexate and Rheumatoid Arthritis: Current Evidence Regarding Subcutaneous Versus Oral Routes of Administration. Adv Ther2016;33:36978. <h3>Disclosure of Interests</h3> Dawn Homer Grant/research support from: This project was supported by an unrestricted educational grant from Nordic Pharma., Consultant for: Participation in an advisory board with Janssen-Cilag in 2018 and will be speaking for Roche-Chugai in March 2019.