Roy Asim, Ito Diane, Morris Susan, Candler Shawn, Profant Judi, Bae Charles
Ohio Sleep Medicine Institute, Dublin, OH, USA.
Stratevi LLC, Santa Monica, CA, USA.
Nat Sci Sleep. 2023 Sep 29;15:767-778. doi: 10.2147/NSS.S411727. eCollection 2023.
Real-world data regarding divided nightly dosing of oxybate and individualized prescribing in patients with narcolepsy are limited. Study objectives were to understand oxybate prescribing practices, including optimizing dose regimens and adjusting dosing per occasional changes in patients' routines, and physician recommendations for representative patient scenarios.
A cross-sectional, web- and audio-based survey of physicians treating ≥2 patients with narcolepsy, prescribed nightly oxybate (sodium oxybate) dosing for ≥6 months, was conducted. Physicians were surveyed on patients' usual oxybate dosing regimens, frequency of and reasons for oxybate dosing-related discussions, and preferred methods for and perceptions of adjusting oxybate dosing. Physicians provided dosing-related guidance for 4 representative scenarios.
Participating physicians (N=25) were neurologists (52%), psychiatrists (44%), and neuropsychiatrists (4%). Individualized oxybate prescribing practices were reflected by the variability of physicians' reporting of the percentage of their patients being prescribed once-nightly, twice-nightly, and thrice-nightly dosing regimens. Most physicians (68%) reported discussing adjusting individualized treatment to accommodate occasional changes to patients' routines; the most common reasons were consuming contraindicated beverages (alcohol; 65%) and travel (59%). Adjusting total nightly dose (68%) and dose timing (68%) were preferred adjustment methods. Most physicians (88%) felt the ability to individualize oxybate dosing was important and had a positive impact on ability to provide care. For each representative scenario, physicians provided several dose-adjustment recommendations, and physician responses encouraged patient participation in treatment decision-making.
Physicians provided guidance supportive of oxybate dose adjustments to accommodate occasional changes in patients' routines, and perceived individualized dosing as important in providing care.
关于发作性睡病患者夜间分次服用羟丁酸钠及个体化处方的真实世界数据有限。研究目的是了解羟丁酸钠的处方实践，包括优化剂量方案以及根据患者日常活动的偶尔变化调整剂量，以及针对典型患者情况的医生建议。
对治疗≥2例发作性睡病患者且每晚开具羟丁酸钠（羟丁酸钠）处方≥6个月的医生进行了一项基于网络和音频的横断面调查。调查了医生关于患者常用的羟丁酸钠给药方案、与羟丁酸钠给药相关讨论的频率及原因，以及调整羟丁酸钠剂量的首选方法和看法。医生针对4种典型情况提供了给药相关指导。
参与调查的医生（N = 25）包括神经科医生（52%）、精神科医生（44%）和神经精神科医生（4%）。医生报告的患者接受每晚一次、两次和三次给药方案的百分比存在差异，这反映了个体化的羟丁酸钠处方实践。大多数医生（68%）报告曾讨论调整个体化治疗以适应患者日常活动的偶尔变化；最常见的原因是饮用禁忌饮料（酒精；65%）和旅行（59%）。调整每晚总剂量（68%）和给药时间（68%）是首选的调整方法。大多数医生（88%）认为能够个体化羟丁酸钠剂量很重要，并且对提供护理的能力有积极影响。对于每种典型情况，医生提供了几条剂量调整建议，医生的回答鼓励患者参与治疗决策。
医生提供了支持调整羟丁酸钠剂量以适应患者日常活动偶尔变化的指导意见，并认为个体化给药在提供护理方面很重要。
