Background

MSProDiscuss^TM is a validated, physician-completed tool aimed at facilitating physician–patient conversation on signs of progression in multiple sclerosis (MS). A set of weighted questions on relapses, symptoms and their impacts as experienced by the patient generate a traffic light system output to aid the discussion. The tool is available online at www.msprodiscuss.com.

Objectives

Evaluate the usability and usefulness of MSProDiscuss in discussing disease progression in daily clinical practice.

Methods

An online qualitative survey consisting of individual questionnaires completed by healthcare professionals (HCPs) after using MSProDiscuss in patient consultations and a final questionnaire to capture overall experience on the tool was conducted in 34 countries. General feedback and recommendations for improving the tool were also collected.

Results

In total, 301 HCPs participated in the survey. The HCPs first completed individual questionnaires after using MSProDiscuss on 6974 MS patients and then a final questionnaire. In 97% (initial questionnaire, i) and 98% (final questionnaire, f) of the time MSProDiscuss was used, the time taken to complete the tool was considered satisfactory (1-4min). The questions were found to be comprehensible in 94% (i) to 97% (f) of cases, and HCPs are willing to use the tool again in the same patient 91% (i) of the time. MSProDiscuss was also useful in discussing MS symptoms and its impact on daily activities (88% i / 92% f) and cognitive function (79% both i and f) and in discussing progression in general (88% i / 90% f).

Moreover, in the final questionnaire, 95% agreed that the questions were similar to those asked by a HCP in a regular consultation. MSProDiscuss was also found to be helpful for understanding the impact of MS symptoms on daily activities (91%) and cognitive function (80%). Overall, 92% of the HCPs would recommend MSProDiscuss to a colleague; 92% think that it is feasible and 86% are willing to integrate MSProDiscuss into their clinical practice. Key recommendations were to allow for longitudinal follow-up, expand on cognitive assessments, and provide a patient-completed version. These have been considered for implementation in the updated version of MSProDiscuss.

Conclusions

The survey results established MSProDiscuss as useful and easy to use tool to facilitate patient-physician discussion of MS progression by structured capturing of patient clinical profile. Most HCPs were willing to integrate MSProDiscuss into their daily clinical practice.

Background

An estimated 240000 people in Germany are living with relapsing multiple sclerosis (RMS), which substantially impacts quality of life. Injectable, infusion and oral disease-modifying therapies (DMTs) are available for treatment; some of the most commonly used first-line DMTs in Germany are glatiramer acetate (GA) including follow-on GA (FOGA), dimethyl fumarate (DMF) and teriflunomide (TER). Little is known about current comparative patient characteristics and outcomes associated with injectable or oral DMTs in the real world.

Objectives

Describe patient demographics, clinical characteristics and treatment patterns (switching/discontinuation) among RMS patients on commonly prescribed DMTs.

Methods

This was a retrospective claims database analysis using data from the Institute for Applied Health Research Berlin database. International Classification of Diseases and Anatomical Therapeutic Chemical Classification system codes were used to identify RMS patients, in the index period 1 Jan 2016 to 31 Dec 2018. Patients were eligible if they had: ≥1 inpatient RMS diagnosis and/or ≥2 outpatient or ≥1 outpatient diagnosis and a DMT prescription in the enrolment period. Patients were naïve for the respective DMT, defined by a 12-month prescription-free period (pre-initiation).

Results

Of 16283 patients with RMS; 1577 patients met all inclusion criteria (GA, n=575; FOGA, n=24; DMF, n=608; TER, n=370). The FOGA group was too small for further analyses. Patients in the TER group were older and had a higher proportion of comorbid hypertension, depression and antidepressant use versus other groups. No other substantial demographic differences were observed. Pre-index mean (standard deviation [SD]) annual overall relapse rate (ORR) was 1.18 (1.19) for GA, 1.18 (1.20) for DMF and 0.99 (1.28) for TER; post-index mean (SD) ORR (12 months post-initiation) was 1.05 (1.56) for GA, 1.00 (1.53) for DMF and 0.86 (1.43) TER. 12 months post-initiation, DMT persistence was 45.9% for GA, 49.7% for DMF and 54.6% for TER; switch rates were 21.0% for GA, 17.4% for DMF and 14.1% for TER.

Conclusions

RMS patients prescribed GA and DMF were generally comparable in demographics, measures of disease activity, and treatment persistence. Despite different administration methods and mechanisms of action, similar ORR and treatment persistence were observed. In contrast, patients prescribed TER were numerically older and exhibited more comorbidities and lower pre-/post-treatment ORR.

Background

MSProDiscuss^TM is a validated, physician-completed tool aimed at facilitating physician–patient conversation on signs of progression in multiple sclerosis (MS). A set of weighted questions on relapses, symptoms and their impacts as experienced by the patient generate a traffic light system output to aid the discussion. The tool is available online at www.msprodiscuss.com.

Objectives

Evaluate the usability and usefulness of MSProDiscuss in discussing disease progression in daily clinical practice.

Methods

An online qualitative survey consisting of individual questionnaires completed by healthcare professionals (HCPs) after using MSProDiscuss in patient consultations and a final questionnaire to capture overall experience on the tool was conducted in 34 countries. General feedback and recommendations for improving the tool were also collected.

Results

In total, 301 HCPs participated in the survey. The HCPs first completed individual questionnaires after using MSProDiscuss on 6974 MS patients and then a final questionnaire. In 97% (initial questionnaire, i) and 98% (final questionnaire, f) of the time MSProDiscuss was used, the time taken to complete the tool was considered satisfactory (1-4min). The questions were found to be comprehensible in 94% (i) to 97% (f) of cases, and HCPs are willing to use the tool again in the same patient 91% (i) of the time. MSProDiscuss was also useful in discussing MS symptoms and its impact on daily activities (88% i / 92% f) and cognitive function (79% both i and f) and in discussing progression in general (88% i / 90% f).

Moreover, in the final questionnaire, 95% agreed that the questions were similar to those asked by a HCP in a regular consultation. MSProDiscuss was also found to be helpful for understanding the impact of MS symptoms on daily activities (91%) and cognitive function (80%). Overall, 92% of the HCPs would recommend MSProDiscuss to a colleague; 92% think that it is feasible and 86% are willing to integrate MSProDiscuss into their clinical practice. Key recommendations were to allow for longitudinal follow-up, expand on cognitive assessments, and provide a patient-completed version. These have been considered for implementation in the updated version of MSProDiscuss.

Conclusions

The survey results established MSProDiscuss as useful and easy to use tool to facilitate patient-physician discussion of MS progression by structured capturing of patient clinical profile. Most HCPs were willing to integrate MSProDiscuss into their daily clinical practice.

Background

An estimated 240000 people in Germany are living with relapsing multiple sclerosis (RMS), which substantially impacts quality of life. Injectable, infusion and oral disease-modifying therapies (DMTs) are available for treatment; some of the most commonly used first-line DMTs in Germany are glatiramer acetate (GA) including follow-on GA (FOGA), dimethyl fumarate (DMF) and teriflunomide (TER). Little is known about current comparative patient characteristics and outcomes associated with injectable or oral DMTs in the real world.

Objectives

Describe patient demographics, clinical characteristics and treatment patterns (switching/discontinuation) among RMS patients on commonly prescribed DMTs.

Methods

This was a retrospective claims database analysis using data from the Institute for Applied Health Research Berlin database. International Classification of Diseases and Anatomical Therapeutic Chemical Classification system codes were used to identify RMS patients, in the index period 1 Jan 2016 to 31 Dec 2018. Patients were eligible if they had: ≥1 inpatient RMS diagnosis and/or ≥2 outpatient or ≥1 outpatient diagnosis and a DMT prescription in the enrolment period. Patients were naïve for the respective DMT, defined by a 12-month prescription-free period (pre-initiation).

Results

Of 16283 patients with RMS; 1577 patients met all inclusion criteria (GA, n=575; FOGA, n=24; DMF, n=608; TER, n=370). The FOGA group was too small for further analyses. Patients in the TER group were older and had a higher proportion of comorbid hypertension, depression and antidepressant use versus other groups. No other substantial demographic differences were observed. Pre-index mean (standard deviation [SD]) annual overall relapse rate (ORR) was 1.18 (1.19) for GA, 1.18 (1.20) for DMF and 0.99 (1.28) for TER; post-index mean (SD) ORR (12 months post-initiation) was 1.05 (1.56) for GA, 1.00 (1.53) for DMF and 0.86 (1.43) TER. 12 months post-initiation, DMT persistence was 45.9% for GA, 49.7% for DMF and 54.6% for TER; switch rates were 21.0% for GA, 17.4% for DMF and 14.1% for TER.

Conclusions

RMS patients prescribed GA and DMF were generally comparable in demographics, measures of disease activity, and treatment persistence. Despite different administration methods and mechanisms of action, similar ORR and treatment persistence were observed. In contrast, patients prescribed TER were numerically older and exhibited more comorbidities and lower pre-/post-treatment ORR.