Gely Cristina, Marín Laura, Gordillo Jordi, Mañosa Míriam, Bertoletti Federico, Cañete Fiorella, González-Muñoza Carlos, Calafat Margalida, Domènech Eugeni, Garcia-Planella Esther
Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain.
Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.
Gastroenterol Hepatol. 2020 Jan;43(1):9-13. doi: 10.1016/j.gastrohep.2019.06.008. Epub 2019 Sep 3.
There is limited information regarding the impact of patients' perception of injection pain on adherence to treatments, specifically in inflammatory bowel disease (IBD) patients. Therefore, we aimed to determine the impact of the pain associated with the subcutaneous administration of adalimumab in patients with IBD treated with the old formulation and the new low-volume/citrate-free formulation.
A specifically-designed questionnaire was completed by 76 patients with IBD, who started treatment with adalimumab before the availability of the low-volume/citrate-free formulation and were switched to this new formulation. Intensity of pain was measured by using visual analog scales (VAS).
A total of 62 patients (82%) experienced injection-related pain with the initial formulation. The perception of pain was associated with a decreased adherence to the treatment (37%), an increase in pre-administration anxiety (25%) or, as a consequence, the patient required someone else to carry out the injection (21%). Younger age was the only factor associated with pain perception. After switching to the new formulation, perception of pain persisted only in 2 patients (3%). Among those who felt pain with the initial formulation, pre-administration anxiety disappeared in 44%; 32% and 42% stated that the new formulation eased adherence and self-administration.
The perception of pain related to the subcutaneous administration of therapy negatively impacts on treatment adherence in IBD patients. Improved formulations for subcutaneous administration of drugs can positively impact patients' convenience and adherence.
关于患者对注射疼痛的感知对治疗依从性的影响，特别是在炎症性肠病（IBD）患者中的相关信息有限。因此，我们旨在确定旧剂型和新型低容量/无柠檬酸盐剂型治疗的IBD患者皮下注射阿达木单抗时疼痛的影响。
76例IBD患者完成了一份专门设计的问卷，这些患者在低容量/无柠檬酸盐剂型可用之前开始使用阿达木单抗治疗，并改用这种新剂型。使用视觉模拟量表（VAS）测量疼痛强度。
共有62例患者（82%）在使用初始剂型时经历了注射相关疼痛。疼痛感知与治疗依从性降低（37%）、给药前焦虑增加（25%）相关，或者因此患者需要他人进行注射（21%）。年龄较小是与疼痛感知相关的唯一因素。改用新剂型后，只有2例患者（3%）仍有疼痛感知。在最初剂型时感到疼痛的患者中，44%的给药前焦虑消失；32%和42%的患者表示新剂型使依从性和自我给药变得更容易。
皮下注射治疗相关的疼痛感知对IBD患者的治疗依从性有负面影响。改进的皮下给药制剂可对患者的便利性和依从性产生积极影响。
