Shapiro Shelley, Bourge Robert C, Pozella Patti, Harris David F, Borg Erick H, Nelsen Andrew C
VA Greater Los Angeles Healthcare System Cardiology Section, David Geffen UCLA School of Medicine, UCLA Medical Center Department of Pulmonary Critical Care, Los Angeles, CA, USA.
Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Pulm Circ. 2020 Apr 22;10(2):2045894020907881. doi: 10.1177/2045894020907881. eCollection 2020 Apr-Jun.
Parenteral prostanoids are effective for improving outcomes in patients with pulmonary arterial hypertension. However, subcutaneous or intravenous delivery via an external pump places a significant burden on patients. Consequently, the Implantable System for Remodulin© (treprostinil) was developed and is associated with a low rate of complications (United Therapeutics (Research Triangle Park, NC) in collaboration with Medtronic, Inc. (Mounds View, MN)). The current real-world experience study evaluated pulmonary arterial hypertension patients' perceptions of their quality of life, ability to perform activities of daily living, perceptions on the benefits and risks of the implantable system, and their social interactions before and after receiving the implantable system. Pulmonary arterial hypertension patients who had been transitioned from an external infusion pump to the implantable system completed a mix of quantitative and qualitative questions administered online over the course of a six-day period. A total of 20 patients completed the study. All patients reported that their quality of life, confidence out in public, and ability to travel long distances had improved. Over 90% of patients reported that their overall level of independence was better since receiving the implantable system, and most patients indicated that their ability to independently perform specific activities of daily living had improved. Responses to the qualitative questions suggested that the implantable system saved time, improved interpersonal relationships, and increased freedom. Results from this real-world patient experience study suggest this novel delivery system provides improvements in factors that are of substantial importance to patients.
胃肠外给予前列腺素类药物对改善肺动脉高压患者的预后有效。然而，通过外置泵进行皮下或静脉给药给患者带来了沉重负担。因此，研发了Remodulin©（曲前列尼尔）植入系统，其并发症发生率较低（联合治疗公司（北卡罗来纳州三角研究园）与美敦力公司（明尼苏达州芒兹维尤）合作）。当前的真实世界经验研究评估了肺动脉高压患者在接受植入系统前后对其生活质量、进行日常生活活动能力、对植入系统益处和风险的认知以及社交互动的看法。从外置输液泵转换为植入系统的肺动脉高压患者在六天时间内在线完成了一系列定量和定性问题。共有20名患者完成了该研究。所有患者均报告其生活质量、在公共场合的信心以及长途旅行能力有所改善。超过90%的患者报告称，自接受植入系统以来，他们的总体独立水平有所提高，大多数患者表示其独立进行特定日常生活活动的能力有所改善。对定性问题的回答表明，植入系统节省了时间、改善了人际关系并增加了自由度。这项真实世界患者经验研究的结果表明，这种新型给药系统在对患者至关重要的因素方面有所改善。
