Home Self-Administration of Biologics – A German Survey among Omalizumab-Treated Patients with Severe Asthma and their Treating Physicians

Abstract

In the EU, five biologics have been approved as add-on therapy for patients with severe asthma. Until recently, none of the biologics was approved for home use and had to be administered under medical supervision, a time-consuming schedule for both patients and physicians, accompanied by greater expenditure. However, over the last year, four out of the five biologics have been granted approval for patient self-administration at home. The objective of this multiple-choice survey was to understand how patients with severe asthma treated with omalizumab and their treating physicians view the potential home use of biologics exemplified by omalizumab. The questionnaires were answered by 120 physicians and 432 patients (response rate: 51.7 % and 20.6 %, respectively). Overall, 44.7 % of patients were in favour of self-administration at home while 30.6 % opposed this method of administration and 23.8 % of patients were neutral. Especially teenagers and young adults had a positive attitude towards self-administration. 76.7 % of the questioned physicians were in favour of home use for certain patients. Time saving was the main advantage for self-administration mentioned by patients (53.2 %) as well as by physicians (72.5 %). The main concern for patients was ‘making a mistake while injecting’ (43.8 %) while ‘forgetting to inject omalizumab’ (73.3 %) was the main concern for physicians. 44.4 % of patients expressed a wish for individual training and 70.8 % of physicians agreed with this statement. The latter group also considered a starter kit including several information materials (54.2 %) as well as an electronic reminder system (50.8 %) as useful. In conclusion, self-administration of biologics has the potential to be timesaving for both patients and physicians.

Zusammenfassung

In der EU sind derzeit 5 Biologika als Add-on-Behandlung bei schwerem Asthma zugelassen. Bisher musste die Administration unter medizinischer Aufsicht erfolgen, was sowohl für Patienten als auch Arztpraxen mit einem erhöhten Zeit- und Kostenaufwand einhergeht. Im Laufe des letzten Jahres wurde allerdings die Selbstapplikation für 4 der 5 Biologika zugelassen. Ziel dieser Umfrage war es, mittels Multiple-Choice-Fragebögen das Potenzial einer Selbstapplikation von Biologika aus der Sicht von Patienten und Ärzten am Beispiel von Omalizumab einzuschätzen. In die Auswertung flossen 432 Patienten- und 120 Ärzte-Fragebögen ein (Rücklaufquote: 51,7 % bzw. 20,6 %). Insgesamt bewerteten 44,7 % der Patienten eine Selbstapplikation positiv, 30,6 % ablehnend und 23,8 % neutral. V. a. in den Altersgruppen der Jugendlichen und jungen Erwachsenen wurde eine Selbstapplikation überwiegend positiv bewertet. 76,7 % der befragten Ärzte würden eine Selbstapplikation für bestimmte Patienten befürworten. Als wichtigster Vorteil wurde bei Patienten bzw. Ärzten v. a. die Zeitersparnis (53,2 % bzw. 72,5 %) genannt. Bedenken äußerten die Patienten v. a. zu Fehlern beim Spritzen (43,8 %), während bei Ärzten am häufigsten „vergessen Omalizumab zu spritzen“ (73,3 %) genannt wurde. Von 44,4 % der Patienten wurde der Wunsch nach einer persönlichen Schulung zur Selbstapplikation als Unterstützung geäußert, während bei den Ärzten neben dieser Unterstützung (70,8 %) v. a. auch ein Starterkit mit verschiedensten Infomaterialien (54,2 %) sowie ein elektronisches Erinnerungs-System (App) als sinnvoll erachtet wurden (50,8 %). Zusammenfassend ergab die Umfrage, dass die praxisexterne Selbstapplikation von Biologika sowohl bei Patienten als auch Ärzten überwiegend befürwortet wurde und zu einer Zeitersparnis beitragen kann.

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