A nurse-led, telephone-based patient support program for improving adherence in patients with relapsing-remitting multiple sclerosis using interferon beta-1a: Lessons from a consumer-based survey on adveva® PSP

Abstract

BackgroundEvidence suggests that organizational models that provide care interventions including patient support programs may increase patient adherence to multiple sclerosis (MS) therapies by providing tailored symptom management, informational support, psychological and/or social support, lifestyle changes, emotional adjustment, health education, and tailored coaching, thus improving patients' overall quality of life across the disease course.ObjectiveThe main objective of this study was to describe MS patients' self-reported experience of a nurse-led, telephone-based PSP and to explore its potential role in improving disease and therapy management skills.MethodsSurvey data were analyzed from a subset of patients relapsing–remitting MS (RRMS) using interferon beta-1a already registered in the adveva® PSP from three Italian multiple sclerosis centers with a consolidated experience in RRMS disease, treatment management, and PSP programs.ResultsIn total, 244 patient data at baseline were analyzed, of which 115 had a follow-up of at least 6 months. Results from this study provide an early view into the role of this PSP in improving the patients reported overall experience regarding disease management and injectable therapy, thus potentially ameliorating treatment adherence and decreasing health care cost. Moreover, study findings confirm the role of providing a patient-focused support by addressing non-medication-related topics in the PSP consultations. Indeed, patients involved in the adveva® PSP program reported a better psychological status in the follow up as demonstrated by an increased optimism regarding their future, tolerance of disease uncertainty, and their perceived ability to benefit from external help and social support (informal caregivers).ConclusionsAs such, it is reasonable to conclude that the involvement in the adveva® PSP and the PSP's assistance in guiding patients on proper treatment self-management techniques is of great value to patients as it might contribute to improving engagement in their health care journey in terms of perceived self-care skills, emotional coping toward the future and the unpredictability of the disease course and their general attitudes toward the injection itself, involving pain tolerance.

Nurse‐led clinics in primary health care: A scoping review of contemporary definitions, implementation enablers and barriers and their health impact

“…Overall, the final group of publications included nine Randomised Control Trials (Bleijenberg et al., 2016; Harrison et al., 2008; Houweling et al., 2011; Imhof et al., 2012; Jacobs et al., 2007; Murchie et al., 2003; Salisbury et al., 2002; Sande et al., 2020; Williams et al., 2005), nine qualitative studies (Clendon & White, 2001; Lindsay, 2001; Marshall et al., 2011; McNeal, 2019; Mills et al., 2012; Minstrell et al., 2015; Nymberg & Drevenhorn, 2016; Pritchard‐Jones et al., 2015; Sullivan et al., 2022), three evaluation studies (Coddington et al., 2011; Dalton et al., 2023; Fernandez, 2007), four cross sectional studies (Fuller et al., 2020; Kor et al., 2022; Krothe & Clendon, 2006; Miles et al., 2003). In addition, four mixed methods studies were included (Frasso et al., 2017; Hammersley et al., 2022; Hegney et al., 2013; Wong & Chung, 2006), along with two cohort studies (Barello et al., 2022; Harvey et al., 2018), two multi‐methods studies (Hegarty et al., 2013), a needs analysis (Clendon & White, 2001), a case study (Callaghan et al., 2012), a secondary analysis (Bleijenberg et al., 2017) and an action research study (Mills & Fitzgerald, 2008).…”

“…A further example included improved management of gout along with a reduced number and severity of gout flare ups (Fuller et al., 2020). In addition, nurse‐led clinics demonstrated improved medication adherence among clients experiencing Multiple Sclerosis (Barello et al., 2022) and those seeking perinatal mental health care (Harvey et al., 2018). In addition, coronary events and mortality were shown to be reduced over 4 years among clients with coronary health disease (Murchie et al., 2003).…”

“…A key finding of this review is that patient and population health impact achieved by nurse‐led clinics, on the most part, were either better than or at least commensurate with GP‐led care. This is regardless of being measured against disease‐specific parameters or outcomes, medication adherence, and lower levels of morbidly and mortality (Barello et al., 2022; Bleijenberg et al., 2016; Bleijenberg et al., 2017; Fuller et al., 2020; Harvey et al., 2018; Houweling et al., 2011; Imhof et al., 2012; Karimi‐Shahanjarini et al., 2019; Laurant et al., 2005; Murchie et al., 2003; Williams et al., 2005; Wong & Chung, 2006). It was nonetheless noted that some nurse‐led care had little to no impact on health behavioural change, such as diet or exercise, or on quality of life (Bleijenberg et al., 2016; Houweling et al., 2011; Imhof et al., 2012; Murchie et al., 2003; Salisbury et al., 2002), but this was not always the case (Hammersley et al., 2022; Williams et al., 2005).…”

“…The positive impacts may be more due to the increased time spent with health care consumers than who was providing care within this time (Karimi‐Shahanjarini et al., 2019). As such it is recommended that further randomised control trials be undertaken, not only to confirm some of the findings already in place, but to also test the efficacy and effectiveness of the various interventions in achieving impactful outcomes (Barello et al., 2022; Callaghan et al., 2012; Hammersley et al., 2022). Studies that examine the best combination and intensity of the various interventions within nurse‐led clinics using more robust methods may be ideal (Bleijenberg et al., 2016).…”