Potential Benefits of the Self-Administration of Subcutaneous Methotrexate with Autoinjector Devices for Patients: A Review

Molina, Jesús Tornero; Robledillo, Juan Carlos López; Ruiz, Núria Casamira

doi:10.2147/dhps.s290771

Cited by 16 publications

(19 citation statements)

References 63 publications

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“…Changes in effectiveness scores have been correlated with changes in 6MWD scores and effectiveness, convenience, and satisfaction scores have been significantly associated with improvements in PAH-specific QoL [ 23 ]. Likewise, the use of auto-injection devices for administering SC methotrexate in rheumatoid arthritis patients increased treatment adherence due to improved patients’ preference and satisfaction [ 16 ]. In this study, high satisfaction with the I-Jet infusion pump coexisted with a high percentage of PAH patients reporting that they were confidently managing SC administration of treprostinil and fully compliant with the treatment after 2 months.…”

Section: Discussionmentioning

confidence: 99%

“…Better treatment adherence and persistence, improved clinical and therapeutic outcomes, and better health-related quality of life might be several outcomes of I-Jet pump use [ 13 , 14 , 15 ]. Nevertheless, patients with chronic conditions report higher adherence and persistence with treatment, confident self-management, and lower total costs with nurse support, medication reminders, injection training, and pen disposal [ 16 ]. Moreover, nurse support improves patient self-management of treatment recommendations and enables patients to discuss their adherence problems with healthcare [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Patient Satisfaction with a Dedicated Infusion Pump for Subcutaneous Treprostinil to Treat Pulmonary Arterial Hypertension

Waligóra

Żuławińska

Tomaszewski

et al. 2023

JPM

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Background and Objectives: Parenteral prostacyclins are crucial in the pharmacological treatment of pulmonary arterial hypertension (PAH). Indeed, subcutaneous administration of treprostinil has been associated with considerable clinical and hemodynamic improvement, right-sided heart reverse remodeling, and long-term survival benefit. However, evidence on patient perceptions about handling a subcutaneous infusion pump for self-treatment administration and nurse views about training the patients are lacking. This study aimed to describe the perception of PAH patients and nurses regarding the use of the new portable I-Jet infusion pump for the self-administration of subcutaneous treprostinil, as well as its real-world training needs. Materials and Methods: The study is an open, observational, prospective, single-center, non-interventional study. Patients with PAH on stable therapy with subcutaneous treprostinil were invited to take part in the study at their start of use of the portable I-Jet infusion pump for the self-administration of treatment. Participants filled in a questionnaire to report their satisfaction with the use of the pump, as well as their compliance, confidence, convenience, preferences, technical issues, and perceptions of the training they received. Results: Thirteen patients completed the questionnaire after being on the pump for 2 months: 69% were females and the mean age was 51 years. The most frequent PAH etiologies were congenital heart disease (46.2%) and idiopathic PAH (38.4%). Most patients were either World Health Organization (WHO) functional class II (53.8%) or III (46.2%). Ten patients (76.9%) found the pump easy and convenient to live with. All patients declared themselves to be fully compliant and confident in using the pump (n = 13) at the end of the study follow-up. Ten patients (76.9%) would choose the new pump in the future. None of the patients made reference to technical issues that required additional hospital visits. Eight patients (61.6%) reported that learning how to use the I-Jet infusion pump was easy or very easy, and none considered that further training was needed. One trainer nurse was interviewed and confirmed the satisfaction of patients and the simplicity of usage and training. Conclusions: PAH patients were highly satisfied with the use of the new portable I-Jet infusion pump for self-administering subcutaneous treprostinil. Convenience and ease of use were valuable and commonly reported features. Moreover, the training requirement was simple. These preliminary findings support the routine use of the I-Jet infusion pump.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction with a Dedicated Infusion Pump for Subcutaneous Treprostinil to Treat Pulmonary Arterial Hypertension

Waligóra

Żuławińska

Tomaszewski

et al. 2023

JPM

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“…Tornero Molina et al (63) recently reviewed the available studies on the use of MTX prefilled pens and how they affected patients in terms of perceptions and treatment adherence. Our findings were consistent with those identified by Tornero Molina et al, in which the majority of the participants generally preferred prefilled pen devices over traditional injectors.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Enablers in the Use of Parenteral Methotrexate in Rheumatoid Arthritis Patients: A Scoping Review

Tan

Reeve

Fraser

et al. 2023

Arthritis Care & Research

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ObjectiveMethotrexate (MTX) is effective in controlling disease activity in rheumatoid arthritis (RA). Parenteral MTX may have benefits over oral MTX, but it is rarely used in practice. To better understand this low usage rate, it is necessary to explore the barriers and enablers of therapy from the perspective of RA patients. The objectives of this scoping review were to describe RA patients’ perspectives on the barriers and enablers in the use of parenteral MTX and to identify the research gaps in this field.MethodsThe search was performed in Medline, Embase, Scopus, and Cochrane Library from inception to May 2021. Data synthesis was conducted using the Theoretical Framework of Acceptability. This scoping review included any type of study that explored the use of parenteral MTX by adult RA patients from the patients’ perspective, written in English.ResultsFifteen studies were included; findings related to the constructs “affective attitude,” “burden,” “intervention coherence,” and “self‐efficacy” were explored the most, while some were rarely (“opportunity cost” and “perceived effectiveness”) or not (“ethicality”) reported. RA patients were generally satisfied with MTX injections (“affective attitude”). From the burden construct, the requirement for dexterity for administering MTX by injection was considered a barrier, whereas the lack of significant pain from MTX injection was considered an enabler.ConclusionThe findings suggested that patients generally preferred parenteral MTX formulations with attributes that facilitate self‐administration. However, much of the identified research focused on prefilled pen devices, and significant gaps were identified, such as a lack of qualitative research.image

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“…Of the 12 videos demonstrating an injection, one-third used a prefilled syringe. Although prefilled syringes have been shown to be preferred by patients and may become a more popular administration tool, depending on the patient's geographical location, they may not be widely available and may be more expensive than traditional syringes 14 . As YouTube is a global platform, videos available may not be entirely relevant to patient experiences across the globe.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Analysis of Methotrexate Self-injection Education Videos on YouTube

2022

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Background: Patients are increasingly turning to the Internet for health guidance, requiring awareness from clinicians of constantly changing resources and quality of available information. A previous study demonstrated a minority of YouTube videos were useful for teaching methotrexate (MTX) self-injection; however, YouTube content constantly evolves, and previous results may not represent current videos. This study provides an update on previous work from 2014 evaluating the quality of YouTube videos demonstrating self-administered subcutaneous MTX injections. Our aim was to evaluate how YouTube videos on MTX injection have changed and evaluate the current video quality.Methods: "Methotrexate injection" was searched on YouTube. The first 75 videos were analyzed independently by 2 reviewers. Videos were classified as useful, misleading/irrelevant, or a personal patient view and rated for reliability, comprehensiveness, and quality.Results: Of the 75 videos reviewed, 12 were classified as useful (16%), 43 misleading/irrelevant (57.3%), and 20 personal patient views (26.7%). Although this represents a substantial increase from previous results in the proportion of videos deemed misleading/irrelevant (57.3% vs. 27.5%) ( p = 0.0011), their reliability and global quality scores were higher. Conclusions:Concordant with the previous study, only a small proportion of the total videos were deemed useful videos for MTX injection specifically. However, reliability and global quality scores for all videos increased from the previous study, suggesting more videos provide reliable information with regard to MTX overall, even if it does not speak to self-injection directly. Logistics of the YouTube algorithm may still impede access to the "best" videos for patient teaching; therefore, clinicians should be prepared to recommend strategies for patients to find high-quality videos.

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Potential Benefits of the Self-Administration of Subcutaneous Methotrexate with Autoinjector Devices for Patients: A Review

Cited by 16 publications

References 63 publications

Patient Satisfaction with a Dedicated Infusion Pump for Subcutaneous Treprostinil to Treat Pulmonary Arterial Hypertension

Patient Satisfaction with a Dedicated Infusion Pump for Subcutaneous Treprostinil to Treat Pulmonary Arterial Hypertension

Barriers and Enablers in the Use of Parenteral Methotrexate in Rheumatoid Arthritis Patients: A Scoping Review

A Qualitative Analysis of Methotrexate Self-injection Education Videos on YouTube

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