Patient experience in healthcare interventions: PROM and PREM evaluation in patients with multiple sclerosis after switching administration route of natalizumab.

Abstract

Objectives: Natalizumab is a disease-modifying drug approved for the treatment of relapsing-remitting multiple sclerosis. It is available as vials for intravenous administration and in 2021 was approved as syringes for the subcutaneous route; both have to be administered in a daycare unit in the hospital. Some studies have addressed the cost-effectiveness of changing the route of administration from intravenous to subcutaneous, but the Patient Reported Outcomes Measures (PROMs) and Patient Reported Experience Measures (PREMs) regarding this change have not yet been studied. The objective of this work is to assess switching from the intravenous route to the subcutaneous route in our centre through the evaluation of PROMs and PREMs.

Methods: An implementation study was conducted to evaluate the PROMs and PREMs of patients after changing the route of administration of natalizumab from intravenous to subcutaneous. An ad hoc questionnaire was developed, in consensus with the neurology team, which was performed by telephone to patients who agreed to participate in the study. The questionnaire was divided into three fields: pain during administration for both routes, patient satisfaction and adverse events of subcutaneous administration.

Results: Forty-seven patients participated in the study. They reported greater pain with subcutaneous administration, but no patient defined it as unbearable. The subcutaneous route was preferred by 97.9% of patients, who stated that this route of administration was less time consuming than the intravenous route. Regarding adverse events, 94.5% patients reported none, and itching was the most common local adverse event reported (29.8%).

Conclusions: This is a novel experience in our setting of collaboration between pharmacy and neurology services to implement PROMs and PREMs in the evaluation of a health intervention. Patients expressed satisfaction with changing the route of administration of natalizumab. This study has enabled us to detect interventions to use to achieve a better patient experience.