Expert Support
Improve treatment outcomes by committing to MS therapy
Isabelle Bedirian, RN
A nurse in Ottawa, ON, Isabelle has been working with MS patients for over 10 years.
Disease-modifying therapies for multiple sclerosis (MS), introduced 10 years ago, substantially improved disease management for people living with MS. This class of medications can reduce disease activity and delay disease progression for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses.(1)
All five disease-modifying therapies currently available are injectables—it’s therefore important to address how the injection routine and method fit into your lifestyle. Both of these factors can affect your motivation and ability to stay on therapy. Disease-modifying therapies are intended for long-term use(2), and in order to achieve their full benefit—fewer and less severe relapses, slowing disease progression and maintaining your ability to enjoy an improved quality of life—the medication should be taken as prescribed by your physician. It’s also wise to ask your healthcare team about what treatment results you could expect, and create a plan to manage potential side effects you may experience over the course of therapy.
Autoinjectors increase comfort and convenience for people with MS
MS experts and healthcare professionals recommend that people continue with their medication and adhere (taking the medication exactly how your physician prescribed it) to their treatment schedule, unless the side effects are too severe or the medication is clearly not working. By continuing with your therapy for the long-term, you increase your chances of experiencing the benefits of disease-modifying therapy.
To help people living with MS and their healthcare teams overcome a number of challenges (both mental and physical) associated with long-term medication administration(3), manufacturers of disease-modifying medications have provided product enhancements to help improve the self-injection process. These developments include the addition of autoinjectors—injection devices that automatically insert the needle and inject a single dose of medication.(3) One of the reasons for selecting an autoinjector over the traditional syringe and needle method is that autoinjectors help users overcome the fear often associated with self-injection. Most autoinjectors conceal the needle and insert it into the skin automatically.(3) One such technological advancement is the new RebiSmart™ (rebismart.ca)—an innovative, personalized electronic autoinjector for MS therapy. This is the first device of its kind for MS therapy administration. RebiSmart™ was specifically designed for comfort and convenience, which are factors that affect adherence. (4) It is unique in that it automatically records all injections—meaning users can track their injection schedule, which can also help improve adherence. RebiSmart™ also gives you more adjustable settings for your comfort than any other MS therapy autoinjector available. These personalized comfort settings can help you minimize the pain and discomfort associated with injection, helping to improve your adherence to therapy and your treatment experience.
Good adherence to your therapy and injection schedule is regarded as one of the best possible strategies for successfully managing MS.(5) Research has shown that stopping treatment may result in the return of pre-treatment disease activity or worse, the disease may progress more rapidly. (5),(6) Research has also shown that improved adherence leads to better treatment outcomes in MS. (7)
Methods to improve adherence
Here are some ways you can improve your MS injection therapy experience to help you optimize treatment adherence:
• Keep a journal or calendar to record your injections so you can benefit from the full potential of your therapy
• Improve your chances of staying on therapy by receiving thorough injection training and learning how to manage injection site reactions (5)
• Decrease anxiety associated with self-injection and needles with devices that keep needles hidden (3)
• Make injections more comfortable and reduce pain and swelling by applying ice before and after
• Work with your healthcare team to understand what you can expect from disease-modifying medications and how they can have a positive impact on your quality of life (5)
References:
1. Goodin DS, et al. Disease modifying therapies in multiple sclerosis: Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines. Neurology. 2002;58;169-78.
2. Litzinger MH, Litzinger M. Multiple sclerosis: a therapeutic overview. US Pharm. 2009;34(1):HS3-9.
3. Barrow-Williams T, Burnell R. Auto-injectors: technology advances and market trends. Innovations in Pharmaceutical Technology (November 2007).
4. Cohen B, Rieckmann P. Emerging oral therapies for multiple sclerosis. Int J Clin Pract. 2007;61(11):1922-30.
5. Ross AP. Tolerability, adherence, and patient outcomes. Neurology. 2008;71(24 Suppl 3):S21-3.
6. National Clinical Advisory Board of the National Multiple Sclerosis Society. Disease management consensus statement. 2007. Available at: http://www.nationalmssociety.org/about-multiple-sclerosis/treatments/index.aspx.
7. Ross AP. Strategies for optimal disease management, adherence, and outcomes in multiple sclerosis patients. Neurology. 2008;71(24 Suppl 3):S1-2.
RebiSmart™ is a trademark of EMD Serono Canada Inc.
This feature is intended solely for informational purposes and is not a substitute for routine or urgent medical evaluation, treatment or consultation. Isabelle Berdirian’s guest editorial should not be construed as a medical opinion aimed at establishing a diagnosis or course of treatment. Individuals who are being treated should not construe information here as replacing or superseding recommendations of their own physician.
