Evaluating home injection compared with healthcare-setting injection of somatostatin analogs: a systematic literature review.

PURPOSE: A systematic literature review was conducted to assess the use of home injections (self/partner/healthcare provider [HCP]-administered) of somatostatin analogs (SSAs) as an alternative to healthcare-setting injections in patients with acromegaly and neuroendocrine tumors (NETs). METHODS: MEDLINE/Embase/the Cochrane Library (2001-September 2021), key congresses (2019-2021), and bibliographies of relevant systematic reviews were searched. Eligible studies reported on efficacy/effectiveness, safety, adherence, patient-reported outcomes (PROs), and economic outcomes in populations receiving home injections of SSAs. RESULTS: Overall, 12 studies were included, all reporting on SSAs (lanreotide Autogel/Depot or octreotide long-acting release) in acromegaly or NETs. Across four studies, home injection was associated with similar disease control in patients with acromegaly/NETs compared with healthcare-setting administration. High rates of treatment adherence were shown in two studies of patients with acromegaly receiving lanreotide injections at home. Two studies reported non-serious adverse events; incidence of adverse reactions was similar in both the home and healthcare administration settings. Preference for injection setting varied between studies and indications; nonetheless, higher satisfaction/convenience (>75% patients) was reported for home injections. Self- or partner-injection was associated with economic savings compared with administration in the healthcare setting across five studies. CONCLUSION: Efficacy/effectiveness, adherence, and safety outcomes of SSAs in the home injection setting were similar to those in the healthcare setting, with high reported satisfaction and convenience. Self/partner injection also resulted in cost savings. These findings provide a basis to understand outcomes related to home injection and encourage healthcare providers to discuss optimal treatment choices with their patients.

Application of continuing nursing care based on Wechat platform in patients with psoriasis by injecting tumor necrosis factor-α antagonist at home / 中国实用护理杂志

Objective:To observe the effect of continuous nursing care based on Wechat platform on the drug safety and compliance in patients with psoriasis at home injection of tumor necrosis factor α (TNF-α) antagonists, so as to provide guidance for patients to use biological agents safely and effectively at home.Methods:A total of 86 patients with moderate to severe psoriasis who were discharged from Dalian Dermatology Hospital from January to December 2020, injected with TNF-α antagonist at home were selected as the study subjects. They were divided into control group and observation group by random digits table method with 43 cases in each group. The control group received routine injection guidance and telephone follow-up; the observation group used continuous nursing care based on Wechat platform on the basis of the control group. Three months after discharge, the medication compliance of the two groups was evaluated by Morisky Medication Adherence Scale-8 (MMAS-8). Before discharge and three months after discharge, the efficacy of the two groups was evaluated by psoriasis area and severity index (PASI). One month after discharge, the adverse reactions of the two groups were counted.Results:The MMAS-8 score was 7.26 ± 1.28 in the observation group and 5.13 ± 1.42 in the control group three months after discharge, the difference was statistically significant ( t = 7.31, P<0.01). There was no significant difference in PASI score between the two groups before discharge ( P>0.05). Three months after discharge, the PASI score was 2.69 ± 1.45 in the observation group and 5.74 ± 1.32 in the control group, the difference was statistically significant ( t = 10.12, P<0.01). The total effective rate was 97.67% (42/43) in the observation group and 93.02% (40/43) in the control group, the difference was statistically significant ( χ2 = 2.35, P<0.05). The incidence of adverse reactions was 6.98% (3/43) in the observation group and 18.60% (8/43) in the control group, the difference was statistically significant ( χ2 = 6.05, P<0.05). Conclusions:In the treatment of patients with psoriasis who inject TNF-α antagonists at home, supplemented with continuous nursing based on Wechat platform can effectively reduce adverse reactions, improve their medication compliance, and improve the safety of home injections Sexuality and effectiveness.

Comparing Self-Injection Teaching Strategies for Patients With Breast Cancer and Their Caregivers: A Pilot Study.

BACKGROUND: A prospective, quasiexperimental pilot study with a sequential design was performed to compare two methods of teaching self-injection. OBJECTIVES: The study examined 50 patients with breast cancer undergoing adjuvant or neoadjuvant treatment and their caregivers to determine if simulation during the teaching experience affects patient/caregiver satisfaction, worry, and self-confidence, as well as nurse satisfaction. METHODS: Structured questionnaires were administered before the teaching, immediately after the teaching, and after the injection was performed at home. Nurses who performed the teaching also completed a questionnaire after the teaching. FINDINGS: Use of simulation did not affect patient/caregiver satisfaction, worry, or self-confidence. The largest impact on learner worry was the actual teaching experience, regardless of the methodology used. Nurses reported greater levels of satisfaction when simulation was part of the teaching. Patient/caregiver satisfaction with the teaching experience decreased after performing the injection at home. Additional research is needed to identify the best methodology for teaching patients and caregivers self-injection. Data from this study revealed that the addition of simulation during teaching does not always translate to better education. In addition, based on patient/caregiver reports, no substitution exists for actual injection administration.