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Hardy TA, Parratt J, Beadnall H, Blum S, Macdonell R, Beran RG, Shuey N, Lee A, Carroll W, Shaw C, Worrell R, Moody J, Sedhom M, Barnett M, Vucic S. Treatment satisfaction in patients with relapsing-remitting multiple sclerosis initiated on teriflunomide in routine clinical practice: Australian observational data. BMJ Neurol Open 2022; 4:e000315. [PMID: 35865788 PMCID: PMC9255404 DOI: 10.1136/bmjno-2022-000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Adherence and persistence are critical to optimising therapeutic benefit from disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS). This prospective, open-label, multicentre, observational study (AubPRO), conducted in 13 hospital-based neurology clinics around Australia, describes treatment satisfaction in patients newly initiated on teriflunomide (Aubagio) and evaluates the use of an electronic patient-reported outcome (PRO) tool. Methods Patients (≥18 years) newly initiated on teriflunomide (14 mg/day) were followed up at 24 and 48 weeks. Patients completed questionnaires and pill counts electronically using MObile Data in Multiple Sclerosis. The primary endpoint was treatment satisfaction, measured by the Treatment Satisfaction Questionnaire for Medication (TSQM, V.1.4), at week 48. Secondary endpoints included treatment satisfaction at week 24, other PRO scales, clinical outcomes, medication adherence and safety. Results Patients (n=103; 54 (52.4%) treatment naive) were mostly female (n=82 (79.6%)), aged 49.5 (11.8) years, with MS duration since symptom onset of 9.1 (11.8) years and a median Expanded Disability Status Scale score of 1.0. Mean treatment satisfaction scores were high (≥60%) across all domains of the TSQM V.1.4 at week 24 and at week 48. Compared with week 24, week 48 treatment satisfaction increased for patients who were treatment naïve and for those previously on another oral or injectable DMT. Over 48 weeks, PROs remained stable across a range of measures including disability, physical health, emotional health and mobility, and there were improvements in work capacity and daily life activity. Adherence was high throughout the study with mean compliance (pill counts) of 93.2%±6.26%, and 98 of 103 (95.1%) patients remained relapse-free. Conclusion This cohort of Australian patients with RRMS, newly initiated on teriflunomide, and treated in a real-world clinical practice setting, reported high treatment satisfaction and adherence at 24 and 48 weeks. Patient-reported measures of disability remained stably low, work capacity and daily life activity improved, and most patients remained relapse-free.
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Affiliation(s)
- Todd A Hardy
- Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - John Parratt
- Department of Neurology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Heidi Beadnall
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Stefan Blum
- Department of Neurology, Princess Alexandra Hospital Health Service District, Woolloongabba, Queensland, Australia
| | - Richard Macdonell
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
| | - Roy G Beran
- Department of Medicine, South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Department of Legal Medicine, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
| | - Neil Shuey
- Department of Neurology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Andrew Lee
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Neurology, Calvary Adelaide Hospital, Adelaide, South Australia, Australia
| | - William Carroll
- Perron Institute for Neurological and Translational Research, Nedlands, Western Australia, Australia
| | - Cameron Shaw
- Geelong Clinical School, Deakin University, Geelong, Victoria, Australia
| | - Richard Worrell
- Sanofi Australia, Macquarie Park, New South Wales, Australia
| | - Jana Moody
- Sanofi Australia, Macquarie Park, New South Wales, Australia
| | - Mamdouh Sedhom
- Sanofi Australia, Macquarie Park, New South Wales, Australia
| | - Michael Barnett
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Steve Vucic
- Brain and Nerve Research Centre, Concord Clinical School, Concord, New South Wales, Australia
- Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
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Vermersch P, Hobart J, Dive-Pouletty C, Bozzi S, Hass S, Coyle PK. Measuring treatment satisfaction in MS: Is the Treatment Satisfaction Questionnaire for Medication fit for purpose? Mult Scler 2016; 23:604-613. [PMID: 27364322 PMCID: PMC5407510 DOI: 10.1177/1352458516657441] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The Treatment Satisfaction Questionnaire for Medication (TSQM) was designed to assess patient treatment satisfaction in chronic diseases. Its performance has not been examined in multiple sclerosis (MS). The 14 items of the TSQM cover four domains: Effectiveness, Side Effects, Convenience, and Global Satisfaction. Objective: To evaluate performance of the TSQM in patients with relapsing MS, using data collected from the TENERE study (NCT00883337), in which 324 patients received oral teriflunomide or subcutaneous interferon beta-1a for ⩾48 weeks. Methods: Five measurement properties were examined using traditional psychometric methods: data completeness, scale-to-sample targeting, scaling assumptions, reliability (including test–retest), and construct validity (internal: item-level scaling success, confirmatory factor analysis, and exploratory factor analysis; external: convergence, discrimination, and group differences). Results: There were few (<2%) missing item data; domain scores could be computed for all patients. Score distributions were skewed toward higher satisfaction; two domains had marked ceiling effects. Scaling assumptions were supported. Internal consistency reliability was high (Cronbach’s α > 0.90). Internal validity tests supported item groupings. Correlations supported convergent and discriminant construct validity; hypothesis testing supported group differences validity. Conclusion: This investigation found the TSQM to be a useful tool, exhibiting good psychometric measurement properties in patients with relapsing MS in the TENERE study.
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Affiliation(s)
| | - Jeremy Hobart
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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