Author Of 1 Presentation
P1043 - Patient coaching to optimize management of delayed-release dimethyl fumarate-associated gastrointestinal events and flushing: Five years of experience (ID 773)
Abstract
Background
Managing the side effect profile of multiple sclerosis (MS) therapies is key to optimize persistence and treatment satisfaction, especially as non-persistence is associated with a greater risk of relapse [1]. It has been shown that persistence and adherence also of oral drugs is not guaranteed [2, 3].
Objectives
In this retrospective cohort study, the real-life situation for German MS patients treated with delayed-release dimethyl fumarate (DMF) regarding the most prominent side effects, gastrointestinal issues (GI) and flushing are evaluated in a five year follow-up.
Methods
German DMF patients were recruited to the patient support program (PSP) from February 2014 onwards. All patients signed a written consent form. Fully supported patients were coached at least twice within the first month of DMF treatment. After the active coaching phase of around 2 years, patients were encouraged to notify the personal coach upon need, but were not actively contacted anymore. After 5 therapy years, all patients were contacted for follow-up information on therapy persistence.
Results
By January 2020, 10,861 DMF patients have been recruited to the PSP, including 3,910 dropouts. Overall, 848 (21.7%) patients reported GI as the main reason for therapy discontinuation, while 339 (8.7%) patients stopped DMF therapy due to flushing. 418 (49.3%) of all discontinuations caused by GI and 26.8% (n=91) caused by flushing presented within the first two months of therapy. Time to therapy discontinuation due to GI was differentiated for fully supported and partially supported patients. After 24 months, 5.7% of fully supported DMF patients (basis 4,758; 273 dropouts) stopped therapy due to GI in contrast to 9.7% (basis 3,849; 374 dropouts) partially supported patients, leading to a 41.2% relative reduction of dropouts (p<0.0001). Preliminary analysis of follow-up information indicates that ongoing disease activity (22.3%, n=145) and changes in blood counts (16.3%, n=106) become the most prominent dropout reasons after two therapy years. Yet, 7.5% and 6% of all dropouts after two years still occur due to GI and flushing, respectively.
Conclusions
Patient support programs including intensive coaching and regular contact can efficiently address and reduce the frequent adherence barriers GI and flushing optimizing therapy persistence. Follow-up indicates the importance of sustainable individual patient coaching for manageable side effects also regarding long-term treatment.
Presenter Of 1 Presentation
P1043 - Patient coaching to optimize management of delayed-release dimethyl fumarate-associated gastrointestinal events and flushing: Five years of experience (ID 773)
Abstract
Background
Managing the side effect profile of multiple sclerosis (MS) therapies is key to optimize persistence and treatment satisfaction, especially as non-persistence is associated with a greater risk of relapse [1]. It has been shown that persistence and adherence also of oral drugs is not guaranteed [2, 3].
Objectives
In this retrospective cohort study, the real-life situation for German MS patients treated with delayed-release dimethyl fumarate (DMF) regarding the most prominent side effects, gastrointestinal issues (GI) and flushing are evaluated in a five year follow-up.
Methods
German DMF patients were recruited to the patient support program (PSP) from February 2014 onwards. All patients signed a written consent form. Fully supported patients were coached at least twice within the first month of DMF treatment. After the active coaching phase of around 2 years, patients were encouraged to notify the personal coach upon need, but were not actively contacted anymore. After 5 therapy years, all patients were contacted for follow-up information on therapy persistence.
Results
By January 2020, 10,861 DMF patients have been recruited to the PSP, including 3,910 dropouts. Overall, 848 (21.7%) patients reported GI as the main reason for therapy discontinuation, while 339 (8.7%) patients stopped DMF therapy due to flushing. 418 (49.3%) of all discontinuations caused by GI and 26.8% (n=91) caused by flushing presented within the first two months of therapy. Time to therapy discontinuation due to GI was differentiated for fully supported and partially supported patients. After 24 months, 5.7% of fully supported DMF patients (basis 4,758; 273 dropouts) stopped therapy due to GI in contrast to 9.7% (basis 3,849; 374 dropouts) partially supported patients, leading to a 41.2% relative reduction of dropouts (p<0.0001). Preliminary analysis of follow-up information indicates that ongoing disease activity (22.3%, n=145) and changes in blood counts (16.3%, n=106) become the most prominent dropout reasons after two therapy years. Yet, 7.5% and 6% of all dropouts after two years still occur due to GI and flushing, respectively.
Conclusions
Patient support programs including intensive coaching and regular contact can efficiently address and reduce the frequent adherence barriers GI and flushing optimizing therapy persistence. Follow-up indicates the importance of sustainable individual patient coaching for manageable side effects also regarding long-term treatment.