Podcast: Adherence to Injectables

00:00:00: You are listening to an ADIS journal podcast.

00:00:06: Hi everybody, my name is Jorge Sanchez and today I want to talk about the adherence to injectables especially to biological therapies because this a very important point specially at present.

00:00:19: but before i going start have make a disclaimer.

00:00:22: This postcast was funded by Novartis But I'm going spread MY opinions that are not necessarily the same opinions of Novartis, and also I have no received any payment for this presentation.

00:00:35: So in these postcards we're going to focus on three points.

00:00:40: first We want to talk about why it's important?

00:00:44: The adherence for injectable therapies.

00:00:46: second...we will try identify those patients with high risk of non-adherence And finally give some tips which could help us to improve adherence in our clinical practice.

00:01:01: For what reason is important the adherence to injectable therapies?

00:01:06: Injectable therapies are used in a lot of medicine areas, for example, rheumatoid disease, dermatologic disease, allergic diseases, neurologic disease and a lot more.

00:01:18: But when we use injectable therapies in chronic disease, it's because that disease is very severe.

00:01:24: So we need to use these therapies to control the disease and sometimes they patient don't want to receive injection.

00:01:33: but for biological therapy this is not an option unless at present Because if you make the introduction of Biological Therapy on other route.

00:01:44: The Biological therapy could be degraded because the acid stomach degraded proteins and in that way, the pharmacotherapy activity is lost.

00:01:54: So we need a less at present—we don't know in the future—use injectable therapies for biological therapies.

00:02:03: It's important to clarify that if you have only one option of injection then there are two big differences Injection first conventional injection traditional injection.

00:02:16: There are those that the patient have to go to a clinical center for application.

00:02:22: This injection has a high spend of time, because they had to go into a clinical centre but also at higher spends on money from their health system as we need to hire people who have localization in order to administer traditional injections.

00:02:40: For other parts how do you inject them?

00:02:43: auto-injectors can be used for the patient at home, in their work or anywhere they are.

00:02:49: And also it reduces costs of health systems because we don't need to have a localization for our application and help people apply injection.

00:02:59: But this has some advance for healthcare physicians as if you had a high number of patients with good clinical control because they have a better adherence without injectors, we'll have more time for those patients with less well-controlled disease.

00:03:16: It's important to select the therapy according to patient preference as there are different options so that we can choose the best option for each patient.

00:03:31: and when we have a chronic disease with high severe disease, we can think that the adherence is not a problem.

00:03:39: If the patient has severe diseases maybe he wants to be more adherent but it's not true.

00:03:45: Some studies suggest that more than fifty percent of patients even with severe disease lost adherence during fallout of their disease.

00:03:54: Why?

00:03:55: Sometimes because they feel well Other times because they don't want to use more therapies and sometimes cause some problems in day-to-day make it difficult for them to be adherents.

00:04:09: For example, when they have to go to a clinical center for the application of injection.

00:04:14: so we have to identify those factors that can affect our patient's adherence and make some potential correction in order to resolve patients' problems and improve their adherence.

00:04:28: What risk factor has been identified with injectable therapies?

00:04:32: Some risks are physical issues, incorrect administration lack of confidence, needle phobia forgetfulness concerns about pain communication problem.

00:04:44: but one point in common have all these risk factors that are modifiable.

00:04:49: We can modify most of this five factors.

00:04:52: for example for needle phobias when the patient has auto-injector they don't see the injection.

00:04:58: so sometimes So the patient used injection because they can apply, but don't see and lost their needle phobia.

00:05:07: And it's very important to have three factors that reduce the risk of no adherence.

00:05:14: First asking about it We ask our patients what are your fears?

00:05:19: Do you have a needle philia?

00:05:20: It is easy for us to go into a clinical center.

00:05:24: What goals do we have?

00:05:26: efficacy of your treatment and your disease.

00:05:29: We have to ask into the patient about their preference, but also we has to assess for other factors—for example how is the age of our patients?

00:05:38: It's not the same if you have a patient with seventy years old or a person who is fifty years old!

00:05:43: You need to know that each group of genders may be having different preferences to select the therapy according with the personal characteristics of the patient.

00:05:57: Different options, different patients and finally during each one of clinical appointments that a patient come we have check about this point.

00:06:06: if you check these constantly will have more possibility or improve their adherence.

00:06:12: for our patients sometimes they don't have time.

00:06:16: The best thing is education a patient consoling, talk with the patient.

00:06:24: But sometimes it's not enough time during the clinical appointment to do this.

00:06:29: so alternative if education programs websites especially from scientific societies have website for the patients and also have guidance for clinical practice for the patient how to use therapies when having to use it identify risk factor or complication And in that way we can give a small explanation during the clinical appointment, but support this explanation with education programs and guidelines that we observe in different websites.

00:07:05: Finally why auto-injectors are important?

00:07:08: Auto-injunctures are important because the patient can have on different studios support better adherence and also reduce time they spend for their disease.

00:07:20: Half a disease is a problem, so we have to try to avoid that the therapy could be an additional problem.

00:07:29: And in that case if we talk with the patient and identify their preference We can select in better way The best treatment for our patients To have high adherence.

00:07:39: Sometimes it has to be the application of traditional injection In clinical centers But If you explain how to use it In most of the cases, they are going to prefer auto-injectors.

00:07:52: And finally some small home messages.

00:07:56: First if a patient has good adherence we have patients with good clinical control.

00:08:02: If we have a patient who is in good clinical condition We will have less assistance to emergency room hospitalization complication and less cost for health systems.

00:08:12: Also these have as consequence that we can spend as a clinical physician more time in those patients with no control.

00:08:20: Thank you so much for your time and I hope that this message could be useful.

00:08:39: The link to the article page can be found in podcast description.