AB0402 MEASURING PATIENT EXPERIENCE OF SWITCHING BIOLOGIC TREATMENT – A SYSTEMATIC LITERATURE REVIEW

ANNALS OF THE RHEUMATIC DISEASES(2019)

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摘要
Background: Biologics have transformed the treatment of inflammatory arthritis (IA).However, the complexity of disease management has increased with the introduction of biosimilars and novel treatments. Hence, patient experience and satisfaction has become increasingly important in treatment individualization. Objectives: Firstly, to assess to what extent IA patient experience of switching biologics is measured in the literature; secondly, to summarize patient-reported outcomes (PROs) as well as medical/non-medical reasons associated with switching. Methods: A systematic literature review (SLR) was performed in accordance with PRISMA guidelines. EMBASE and MEDLINE were searched for relevant publications from 2013 to present day, together with relevant conference abstracts from 2018 (ACR-ARHP, EULAR, and ISPOR). Studies published in English including either a) patient-reported outcomes (PROs) associated with switching biologics, or b) reasons for switching and/or discontinuing biologics treatment as noted by health care professionals and/or patients were included. The scope was limited to European and North American populations. While the initial search included patient populations with ulcerative colitis in addition to IA patients, results presented within this abstract focus on IA populations only. Results: After initial screening of 1781 abstracts, sixty-eight studies including IA patients were identified for inclusion in the analysis. Of the remaining studies, 39/68 (57%) included ≥1 treatment switch. The majority of studies were conducted in Europe (36/39; 92%), with the proportion of female patients ranging between 12-90%. Thirteen studies (18%) included at least one PRO, 4 of which only recorded PROs prior to switch (6%). The most commonly reported PRO was PGA/VAS, followed by HAQ and questions asking patients to rank their switching experience using various pre-defined categories (Figure 1). While the most common reasons for discontinuing treatment, which may or may not include switching, was provided in 33 studies (loss of efficacy and safety), reasons strictly for switching are infrequently reported. Conclusion: Patient satisfaction is important, as it has been linked to clinical safety, treatment effectiveness, and adherence (Doyle et al., 2013). However, this SLR highlights a notable lack of information regarding patient-reported experience of switching biologic treatment. The PROs reported in a minority of studies encompass several regions related to patient well-being – such as pain, fatigue, etc. – but provides very limited information on the experience of switching. Hence, to improve disease management and treatment individualization, further research is required. Reference [1] Doyle, et al. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open, 2013. Disclosure of Interests: Mary Dozier Consultant for: Mary Dozier is an employee of ICON PLC and has received consulting fees from Merck & Co., Inc, Karin Luttropp Consultant for: Karin Luttropp is an employee of ICON PLC and has received consulting fees from Merck & Co., Inc, Axel Svedbom Consultant for: Axel Svedbom is an employee of ICON PLC and has received consulting fees from Merck & Co., Inc, Johan Dalen Consultant for: Johan Dalen is an employee of ICON PLC and has received consulting fees from Merck & Co., Inc, Christopher Black Shareholder of: Christopher Black is a shareholder in Merck & Co., Inc., Kenilworth, NJ USA, Employee of: Christopher Black is an employee of Merck & Co., Inc., Kenilworth, NJ USA, Amy Puenpatom Shareholder of: Amy Puenpatom is a shareholder of Merck & Co., Inc., Kenilworth, NJ USA, Employee of: Amy Puenpatom is an employee of Merck & Co., Inc., Kenilworth, NJ USA
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