The purpose of the study was to assess the preferences of rheumatologists and patients with rheumatoid arthritis regarding the methods and frequency of biological drug administration. Patients were questioned about problems and difficulties associated with the use of biological medications (in particular, the perception of pain upon drug administration). Questions covered a range of issues including self-injection, help provided by relatives and friends or medical personnel, the preferred route of drug administration and dosing frequency, the degree of satisfaction with the effectiveness and safety of currently available therapies, unmet needs in relation to biological therapies, and what would be the ideal rheumatoid arthritis (RA) biological therapy product.
Material and methods: The survey, part of the international RAISE project, conducted in the form of a standardized personal interview by trained interviewers using a paper and pencil interview method, included 30 rheumatologists actively involved in the use of biological therapies and 120 patients receiving biological medications subcutaneously (52%) or intravenously (48%).
Results: Doctors rated performance of a subcutaneous injection by patients as easy or very easy; in their opinion patients rarely experience difficulty opening drug packaging (14%); however, problems do occur more frequently if using an injector (43%). The subcutaneous route of administration is preferred by 83% of patients, who rarely opt for intravenous therapy (3%). According to doctors, 85% of patients self-inject their medication and their preferred frequency of drug administration is once per month. Twenty patients (17%) reported having difficulties opening drug packaging and 19 (16%) experienced problems handling the injector. Twenty-nine patients (24%) reported experiencing fear at the prospect of inserting a needle into their body. Adverse reactions following subcutaneous drug administration occurred in 29 patients and in 12 patients following intravenous drug administration (24% vs. 10%). The most frequently reported complaints were pain (20 patients, i.e. 17%) and allergic reactions at the site of injection (10 patients; 8%). For this reason someone other than the patient, usually a nurse, performed the injections for one in four patients. Subcutaneous drug administration was the preferred route for 46 patients (38%) while 47 preferred intravenous delivery (39%); for the remainder, the route of administration was immaterial. Patients preferred a dosing schedule of once a month or less.
Conclusions: The study revealed significant discrepancies in preferences between doctors and patients. Therefore it is the authors’ opinion that patients should participate in the process of choosing the route of drug administration.