Understanding and meeting injection device needs in multiple sclerosis: a survey of patient attitudes and practices

Figures & data

Table 1 Survey questionnaire

Question	Response
1. Thinking generally about new technologies, how comfortable would you say you were with technical electronic instruments such as computers and mobile phones?	Scale of 0 (not at all) to 10 (very comfortable)
2. Which of the following best describes your approach to new technologies?	I am always one of the first to try new technologies (early adopter) I tend to wait until others have tried and tested a new technology before using it myself (cautious adopter) I am usually amongst the last to start using a new technology (late adopter)
3. Which of the following types of MS do you currently have?	Relapsing–remitting Secondary progressive Clinically isolated syndrome Don’t know
4. How long ago were you first diagnosed with MS?	Length of time
5. For how long have you been injecting this MS treatment?	Length of time
6. Which of the following do you currently use to inject your MS treatment?	A syringe that requires you to fill from a vial A prefilled syringe Autoinjection device
7. Do you currently inject yourself or do you have someone else inject for you?	I inject myself Someone else injects me Both
8. For which of the following reasons do you not currently inject your treatment yourself?^a	I find it physically difficult to inject myself It hurts to inject myself I don’t like looking at needles I don’t like the thought of having to inject myself I don’t trust I will inject myself correctly I find the syringe/injection device unsafe Other^b
9. How satisfied would you say you were with the injection method you currently use for administering treatment?	Scale of 0 (not at all) to 10 (very satisfied)
Questions after viewing presentation on the new electronic, multidose autoinjector
10. How appealing is this new injection device compared with your current method?	Scale of 0 (not at all) to 10 (very appealing)
11. Which of the following do you feel are the key benefits of this new electronic device that would encourage you to ask your nurse or doctor about it?^a	Ability to tailor injection settings to individual patient needs Reliable monitoring of regular dosing Could allow for easier access to various injection sites Simple uncomplicated procedure Hidden needle Sounds, lights, and onscreen prompts ensure correct and confident delivery of dose Looks easy to grip and handle the device Compact Ability to download dosing information to computer Looks less like a medical device Other^b There are no benefits
12. Which of the following do you feel are the key drawbacks of this new electronic device that would discourage you from asking your nurse or doctor about it?^a	The device may malfunction Requires a screwdriver to change batteries Too many steps to prepare the injection Too many steps involved in actually injecting Could be too large to handle comfortably Information screen could be difficult to read Patient is less in control of the injection Dosing log implies a lack of physician’s trust Other^b There are no drawbacks to using this device

Notes:

a Respondents could give more than one reason, benefit, or drawback;

b other benefits or drawbacks cited by patients were recorded.

Abbreviation: MS, multiple sclerosis.

Table 2 Patient demographic and clinical characteristics

Characteristics
Age, years
Mean (SD)	43 (10.7)
Median (range)	44 (18–64)
Age range, n (%)
18–30 years	72 (17)
31–40 years	122 (29)
41–50 years	126 (30)
51–65 years	102 (24)
Sex, n (%)
Male	127 (30)
Female	295 (70)
Clinical form of MS, n (%)
Clinically isolated syndrome	40 (9)
Relapsing–remitting	300 (71)
Secondary progressive	57 (14)
Unknown	25 (6)
Time since diagnosis of MS, years
Mean (SD)	8.4 (6.7)
Median (range)	6 (1–41)
Length of time injecting MS therapies, years
Mean (SD)	4.2 (3.6)
Median (range)	3.2 (0.2–36.5)

Abbreviations: MS, multiple sclerosis; SD, standard deviation.

Figure 1 Current method of injection administration.

Abbreviations: IFN, interferon; im, intramuscular; sc, subcutaneous.

Figure 2 Reasons given for not self-injecting. Respondents could give more than one reason (values total more than 100%). Physical (total) score is the percentage of respondents selecting one or both of the two physical reasons; psychological (total) score is the percentage of patients selecting one or more of the psychological reasons.

Table 3 Satisfaction with current injection method

Method of injection	Satisfaction score
	Mean	Median	Range	Category (percentage of patients)
				0–2 “unsatisfied”	3–7 “moderately satisfied”	8–10 “very satisfied”
All patients (n = 422)	6.7	7.0	0–10	6	54	40
Vial and syringe (n = 53)	5.9	6.0	1–10	8	69	23
Prefilled syringe (n = 183)	6.7	7.0	0–10	6	55	39
Autoinjection device (n = 186)	6.9	7.0	0–10	5	49	46

Figure 3 Benefits of the new autoinjection device most commonly cited by patients. Respondents could cite more than one benefit (values total more than 100%).