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#Post#: 484--------------------------------------------------
(Abst.) Patient care program for adjusting autoinjector needle
depth...
DIR By: agate
Date: September 17, 2014, 7:07 pm
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It's unusual to find a research article where the day-to-day
practical problems of coping with MS injections are addressed,
but here is one.
From PubMed, September 17, 2014:
--- Quote ---
> J Neurosci Nurs. 2014 Sep 14.
>
> A Patient Care Program for Adjusting the Autoinjector Needle
Depth According to Subcutaneous Tissue Thickness in Patients
With Multiple Sclerosis Receiving Subcutaneous Injections of
Glatiramer Acetate
>
> Masid ML1, Ocaña RH, Gil MJ, Ramos MC, Roig ME, Carreño MR,
Morales JC, Carrasco ML, Hidalgo LM, Felices AM, Castaño AH,
Romero PC, Martinez PF, Sánchez-De la Rosa R.
>
> Author information
>
> 1Maria Luisa Sánchez Masid, D.U.E., is an MS Expert Nurse at
H. Universitario de Ourense, Ourense, Spain. Rosalía Horno
Ocaña, D.U.E., is an MS Expert Nurse at Vall d'Hebrón,
Barcelona, Spain. María Jesús Díaz Gil, D.U.E., is an MS Expert
Nurse at H. Clínico San Carlos, Madrid, Spain. Maria Concepción
Ramírez Ramos, D.U.E., is an MS Expert Nurse at H. Clínico San
Carlos, Madrid, Spain. Matilde Escutia Roig, D.U.E., is an MS
Expert Nurse at H. La Fe, Valencia. Maria Rosario Coll Carreño,
D.U.E., is an MS Expert Nurse at H. Carlos Haya, Málaga. Jaime
Cordero Morales, D.U.E., is an MS Expert Nurse at H. Carlos
Haya, Málaga. Maria Luisa Vergara Carrasco, D.U.E., is an MS
Expert Nurse at H. Carlos Haya, Málaga. Leonor Mariana Rubio
Hidalgo, D.U.E., is an MS Expert Nurse at H. Carlos Haya,
Málaga. Ana Maria Bernad Felices, D.U.E., is an MS Expert Nurse
at H. Clínico de Valencia, Valencia. Adela Harto Castaño,
D.U.E., is an MS Expert Nurse at H. Gregorio Marañón, Madrid.
Purificación Castañeda Romero, D.U.E., is an MS Expert Nurse at
H. Puerta del Mar, Cádiz. Questions or comments about this
article may be directed to Pablo Francoli Martinez, PhD, at
pablo.francoli@tevaes.com. He is a Medical Science Liason at
Medical Department, TEVA Pharma S.L.U., Anabel Segura, 11,
Edificio Albatros B, 1st floor, 28108 Alcobendas, Madrid, Spain.
Rainel Sánchez-De la Rosa, MD PhD MSc, is the Medical Director
and Head of Market Access, Teva Pharma Group, Madrid, Spain.
>
> Background:
>
> The perceived pain on injection site caused by subcutaneous
(SC) self-injection may negatively affect acceptance and
adherence to treatment in patients with multiple sclerosis (MS).
Pain on injection may be caused by inaccurate injection
technique, inadequate needle length adjustment, or repeated use
of the same injection body area. However, information is lacking
concerning the optimal needle depth to minimize the injection
pain.
>
> Objective:
>
> The purpose of this program was to characterize the perceived
injection-site pain associated with the use of various injection
depths of the autoinjector of glatiramer acetate (GA) based on
SC tissue thickness (SCT) of the injection site. Methods: This
was a pilot program performed by MS-specialized nurses in
patients with MS new to GA. Patients were trained by MS nurses
on the preparation and administration of SC injection and on an
eight-site rotation (left and right arms, thighs, abdomen, and
upper quadrant of the buttock). The needle length setting was
selected based on SCT measures as follows: 4 or 6 mm for SCT <
25 mm, 6 or 8 mm for SCT between 25 and 50 mm, and 8 or 10 mm
for SCT > 50 mm. Injection pain was rated using a visual analog
scale (VAS) at 5- and 40-minute postinjection and during two
24-day treatment periods.
>
> Results:
>
> Thirty-eight patients with MS were evaluated. The mean SCT
ranged from 15.5 mm in the upper outer quadrant of the buttocks
to 29.2 mm in the thighs. The mean perceived pain on injection
was below 3 for all the injection sites, at both time points (5
and 40 minutes) and during both 24-day evaluation periods. The
mean VAS scores were significantly greater after 5 minutes of
injection compared with that reported 40-minute postinjection
during both 24-day treatment periods and for all the injection
areas. Mean VAS measures at 5- and 40-minute postinjection
significantly decreased during the second 24-day treatment
period with respect to that reported during the first 24 SC
injections for all injection sites.
>
> Conclusions:
>
> Our findings suggest that the adjustment of injection depth of
SC GA autoinjector according to SCT of body injection areas is
suitable to maintain a low degree of postinjection pain.
Moreover, our results also may indicate that the use of needle
lengths of 6 mm or shorter is appropriate with regard to
injection pain for adult patients with MS with SCT < 50 mm.
--- End Quote ---
The abstract can be seen here
HTML http://www.ncbi.nlm.nih.gov/pubmed/25225835.
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