By Joe Reynolds
A primary goal of rheumatologists remains alleviating the pain, stiffness and tenderness that mark rheumatoid arthritis (RA). Yet in an era marked by a significant increase in self-injection options, it has become crucial for these HCPs to understand just how well their patients are self-administering their medications.
Currently, most RA patients undergo a single initial training session in their HCP’s office with a true drug delivery device—not a training device—and then are left unsupervised and unguided for the course of treatment. Because patients are on their own, there is significant variation in how well they self-inject at home. Research suggests successful adherence may hinge upon whether the treatment prescribed is supported by training materials that go beyond what is provided at a typical introductory session in the office and the standard Instructions for Use (IFU).
In the quest to address their symptoms, RA patients rely on a range of biologic treatments that involve self-injection. Patients often see self-injecting as a daunting task, making proper training and onboarding critical. Research has suggested that 45% of patients skip or altogether avoid injections due to anxiety or fear for a number of reasons—fear of needles; fear of a “wet injection,” or removing the needle prematurely, which leads to a less-than-complete dose; fear of injecting in the wrong place on the skin or at the wrong angle; and more.
While this statistic itself is striking, one study focusing specifically on self-injecting RA patients went as far as to note that about half of participants reported not feeling confident self-injecting. Notably, older patients were more likely to request that HCPs inject their medications for them. This is significant because the onset of RA is highest for adults in their 60s.
Additional findings suggest that the natural memory decay patients experience—in conjunction with the longer periods of time between injections that accompany newer therapies—highlights even further the value of training devices in the home to utilize throughout treatment and not merely a single time in an HCP office. Recurring use of training devices reinforces positive behaviors and helps combat patients’ natural loss of memory.
Noble’s recent longitudinal study set out to leverage secondary research findings to add further merit to the importance of training devices. The study uncovered how patients interact with training devices and results supported the need for trainers. One hundred percent of participants supplied with a training device to practice with in their home successfully completed all critical steps involved in self-injecting following a practice period of two weeks. In contrast, more than 50% of participants not supplied with training devices committed critical injection errors.
It is clear that RA patients both desire and can benefit from these extra resources and support to feel more confident at home. What’s more, further research suggests 92% of patients would prefer to receive and practice with training devices in the home. Astonishingly, adherence rates to therapies balloons to a whopping 94% when even more support, such as formal patient support programs, is supplied.
One reason training devices and robust training solutions likely play such a positive role for patients is because they include a variety of high-tech features that allow the realistic practice of self-injections. High-quality trainers can replicate drug viscosity, plunger speed and even feel of the injector tip on the skin and can give audible feedback that mimics the sound of an actual drug delivery device. One study concluded that 86% of patients reported increased confidence in self-injecting with training devices. This is imperative to note because higher patient confidence leads to stronger adherence to medication, which leads to better outcomes for patients and HCPs across the board.
With the steady increase in the popularity of self-injectable therapies, it has become increasingly vital that HCPs understand their patients’ level of familiarity and comfort with this form of administration. In order to avoid errors, reduce anxiety and take the guesswork out of self-injections, a high-quality standard of training and onboarding must be established as part of the standard of care. Considering research suggests 86% of patients make errors with autoinjectors, addressing this issue is a must.
HCPs should inquire with their reps about whether their most commonly prescribed self-injection medications are accompanied by a training device to support patients during both in-office training and for continued use at home.
The ideal outcome of this proactive stance could be a new generation of satisfied RA patients—a generation that is more assured that its self-treatment will result in the symptom relief that it both expects and deserves.
Joe Reynolds is Research Manager at Noble, the global leader in biopharma onboarding and device training.