Early Interferon Beta Treatment in Multiple Sclerosis: Nursing Care Implications of the BENEFIT Study

Ottawa Hospital, Ottawa, Ontario, Canada.
Journal of Neuroscience Nursing (Impact Factor: 0.82). 01/2009; 40(6):356-61. DOI: 10.1097/01376517-200812000-00008
Source: PubMed


Interferon beta (IFNbeta) is a first-line treatment for relapsing forms of multiple sclerosis (MS) that can reduce the rate of clinical attacks and limit disability progression. Recent trials have shown that initiating IFNbeta treatment at the time of the first clinical event suggesting MS can delay the onset of clinically definite MS and, in the case of IFNbeta-1 b, inhibit the progression of later disability. These findings have led to a trend toward earlier treatment initiation in clinical practice. While trials show good levels of adherence to therapy, there often is room for improvement in the clinical setting. Managing MS symptoms and treatment-related adverse events and providing patient education are vital to optimize adherence, and nurses can employ a number of strategies as part of the support program to ensure patients gain the most benefit from their treatment. In addition to providing a great deal of evidence supporting early MS treatment, the ongoing BEtaseron in Newly Emerging multiple sclerosis For Initial Treatment (BENEFIT) study has highlighted the fact that IFNbeta can be well tolerated, especially with correct management. This article summarizes the lessons learned from the BENEFIT study, and the ways in which nurses can incorporate this knowledge into clinical practice.

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    ABSTRACT: To evaluate the satisfaction level of multiple sclerosis (MS) patients treated with interferon beta-1b (IFNbeta-1b, Betaferon*) using a newly developed application system compared to their currently used application system. A survey was conducted in Portugal in patients treated with IFNbeta-1b for relapsing-remitting MS with the Betaject or Betaject Lite autoinjector. Nurses demonstrated the new application system and supervised the first injection. Patients rated their overall satisfaction retrospectively with their current application system and prospectively after the first, the seventh and the 15th injection with the newly developed application system. Additionally, the ease of use was evaluated for both application systems using a questionnaire consisting of 13 questions. Responses were compiled and descriptive analyses performed. A total of 249 patients evaluated the current and the new system after the first, 235 after the seventh and 174 after the 15th injection. The satisfaction level was high with the current system (70.3%, 'satisfied' or 'very satisfied'). However, compared with the current system, more patients were either 'satisfied' or 'very satisfied' (98%) with the new system after first injection. Only a minority of patients rated 'somewhat satisfied': 2.0% after the first, 8.6% after the seventh, and 4.4% after the 15th injection. Increased overall satisfaction level ('satisfied' or 'very satisfied') with the newly developed system was maintained over time (98% - first, 90.5% - seventh, 93.8% - 15th injection). The thinner, pre-attached 30-gauge needle and the visual signalling of injection completion were among the changes considered as strong improvements to the new system by up to 80.3% of patients. Retrospective analysis of current system. This survey documented patient satisfaction with different application systems of IFNbeta-1b. The increased satisfaction with the new application system indicates an improvement to the currently used injection system, which may contribute to further advancement in adherence and consequently higher clinical efficacy of treatment.
    No preview · Article · Sep 2010 · Current Medical Research and Opinion
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    ABSTRACT: Long-term adherence to disease-modifying therapy in relapsing-remitting multiple sclerosis (RRMS) is associated with improved patient outcomes, including a reduced risk of relapse and a better preserved quality of life. However, the unpredictable nature of the disease--even when it is being treated--may make it difficult to convince patients of the importance of treatment adherence. A number of studies have attempted to pinpoint factors that affect adherence. Nursing interventions that address some of these factors may improve adherence and, thus, the disease course for a variety of RRMS patients. This article summarizes literature that approximates the prevalence and impact of nonadherence and reviews factors identified in clinical trials that affect adherence. Nursing interventions that can improve adherence, including telephone counseling and motivational interview techniques, are also addressed.
    No preview · Article · Oct 2010 · Journal of Neuroscience Nursing
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    ABSTRACT: The treatment of multiple sclerosis (MS) has advanced greatly since the introduction of disease-modifying therapies (DMTs) in the early 1990s. Although the DMTs have exhibited significant efficacy in relapsing-remitting MS and other forms of the disease, the degree of benefit depends heavily on patient adherence to recommended regimens. This article addresses some of the most pressing areas of unmet need in educating advanced-practice nurses, neurologists, patients, and support care partners regarding strategies that can overcome obstacles to adherence. The observations presented here are based on clinical experience with real-life cognitive, psychosocial, and cultural impediments to adherence. The article also explores the ways in which adherence may be affected by emerging therapies for MS (such as oral agents) as well as the educational needs that will arise with the further evolution of MS care.
    No preview · Article · Oct 2010 · Journal of Neuroscience Nursing
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