Overton Paul M, Shalet Natalie, Somers Fabian, Allen Jeffrey A
Beacon Medical Communications, Brighton, UK.
NAS Healthcare Solutions, London, UK.
Patient Prefer Adherence. 2021 Apr 19;15:811-834. doi: 10.2147/PPA.S303279. eCollection 2021.
For many chronic immune system disorders, the available treatments provide several options for route of administration. The objective of this systematic literature review is to inform discussions about therapy choices for individual patients by summarizing the available evidence regarding the preferences of patients with chronic immune system disorders for intravenous (IV) or subcutaneous (SC) administration.
Searches of the MEDLINE, Embase and Cochrane Library databases were conducted using terms designed to capture studies reporting patient preferences between IV and SC therapy published in English. Relevant studies were limited to those in which mode of administration, including treatment frequency and setting, was the main difference between comparators.
In total, 49 studies were included in the review. Among 18 studies that compared IV and SC immunoglobulin therapy, 16 found patients to prefer the SC administration route. The results of the 31 studies comparing IV infusion and SC injection of non-immunoglobulin therapies were mixed, with patients favoring SC administration in 20, IV infusion in seven, and having no overall preference in four. Patient experience had a strong effect on preferences, with treatment-experienced patients preferring their current administration route in most studies. Patients preferring SC administration tended also to prefer treatment at home, mainly due to the convenience and comfort of home treatment and the avoidance of having to attend hospital. By contrast, patients preferring IV infusion tended to cite the lower treatment frequency and a dislike of self-injecting, and preferred hospital treatment, mainly due to the presence of healthcare professionals and resulting feelings of safety.
In general patients with chronic immune system disorders tend to be more likely to choose SC administration than IV infusion, but preferences may vary according among individuals. These findings may assist discussions around appropriate treatment choices for each patient.
对于许多慢性免疫系统疾病，现有的治疗方法提供了多种给药途径选择。本系统文献综述的目的是通过总结关于慢性免疫系统疾病患者对静脉注射（IV）或皮下注射（SC）给药偏好的现有证据，为针对个体患者的治疗选择讨论提供信息。
使用旨在检索以英文发表的报告患者对IV和SC治疗偏好的研究的术语，对MEDLINE、Embase和Cochrane图书馆数据库进行检索。相关研究仅限于那些给药方式（包括治疗频率和环境）是比较组之间主要差异的研究。
本综述共纳入49项研究。在18项比较IV和SC免疫球蛋白治疗的研究中，16项发现患者更喜欢SC给药途径。31项比较非免疫球蛋白治疗的IV输注和SC注射的研究结果不一，20项研究中患者倾向于SC给药，7项倾向于IV输注，4项没有总体偏好。患者的体验对偏好有很大影响，在大多数研究中，有治疗经验的患者更喜欢他们当前的给药途径。倾向于SC给药的患者也倾向于在家中接受治疗，主要是因为家庭治疗的便利性和舒适性以及无需去医院。相比之下，倾向于IV输注的患者倾向于提及较低的治疗频率和不喜欢自我注射，并且更喜欢在医院接受治疗，主要是因为有医护人员在场并因此产生安全感。
一般来说，慢性免疫系统疾病患者比IV输注更倾向于选择SC给药，但个体之间的偏好可能会有所不同。这些发现可能有助于围绕每位患者的适当治疗选择进行讨论。
