BackgroundSubcutaneous interferon beta-1a (sc IFN β-1a) therapy (44 µg or 22 µg, three times weekly) improves relapse rates and disability progression in patients with relapsing multiple sclerosis (MS). While early treatment with disease-modifying drugs may maximize therapeutic benefit, patients with low adherence or long treatment gaps are at increased risk of relapse. MySupport is an industry-sponsored program that provides support to patients with MS who have been prescribed sc IFN β-1a in the UK or Republic of Ireland (ROI), via telephone and text messaging, website access, and (in some cases) face-to-face support from a dedicated MySupport Nurse. The aim of this audit was to assess if the MySupport program in the ROI could improve persistence to sc IFN β-1a therapy.MethodsAnonymized data were supplied retrospectively from the MySupport program, for ROI patients who were registered in January 2010 to receive sc IFN β-1a three times weekly. Patients were recorded as “new” at their first drug delivery; “active”, if they continued to receive scheduled deliveries; “interrupted”, if their medication delivery was halted; or “stopped”, if no deliveries were made for 12 months. The number of “active” patients was recorded monthly for 24 months. Results were compared with data from UK patients with MS, who were receiving National Health Service (NHS) support only, or this support plus MySupport.ResultsA greater proportion of ROI patients receiving MySupport (compared against UK patients receiving NHS support only) were on treatment at 12 months (87.8% versus 79.3%) and at 24 months (76.2% versus 61.8%). The odds of being on treatment were significantly greater, at all time points, for ROI patients receiving MySupport, versus UK patients receiving NHS support only (P<0.0001).ConclusionA personalized support program, utilizing one-to-one nursing support and additional support materials, can increase the probability of patients with MS remaining on disease-modifying drug treatment.

We investigated the safety, tolerability and efficacy of nefazodone and paroxetine in the continuation phase of treatment of depression. The study comprised a double-blind, parallel-group comparison over 4 months, of patients who had previously improved following random allocation to nefazodone or paroxetine during an 8-week acute treatment study. Assessments included Clinical Global Impression Scales, Hamilton Rating Scales for Depression and Anxiety, Montgomery-Asberg Depression Rating Scale and the Patient Global Assessment Scale, in addition to a review of reported adverse events, vital sign measurements, electrocardiograms and clinical laboratory tests. One hundred and eight patients participated in the continuation study (53 received paroxetine, 55 nefazodone) and 73 completed treatment. No clinically relevant differences in antidepressant efficacy were seen. Headache and somnolence were the most common reported adverse events in both treatment groups. Both nefazodone and paroxetine maintain their efficacy in continuation treatment, and both are generally well tolerated.

Background: People with multiple sclerosis (MS) receiving disease-modifying therapy must persist with their treatment for the prescribed duration and adhere to the prescribed interval and dose to achieve the full benefits. Aim: This audit aimed to assess whether the MySupport programme for patients with MS could improve persistence with subcutaneous (sc) interferon (IFN) β-1a. Methods: Anonymised data was retrospectively supplied by homecare providers for patients registered to receive sc IFN β-1a in January 2010. The number of ‘active’ patients (those continuing to receive scheduled deliveries) was recorded monthly for 24 months for patients receiving NHS treatment alone and those receiving both NHS treatment and MySupport. Results: A greater proportion of patients receiving NHS treatment and MySupport than of patients receiving NHS support only were on treatment at 12 months (90.0% vs 79.3%) and 24 months (74.9% vs 61.8%). The odds of being on treatment were significantly greater in patients receiving NHS treatment and MySupport than NHS support only at all time points (P<0.0001). Conclusion: A personalised support programme using one-to-one nursing support and additional support media can increase the likelihood of patients with MS remaining on sc IFN β-1a.

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