Autoinjector preference in multiple sclerosis and the role of nurses in treatment decisions: results from an international survey in Europe and the USA

PURPOSE: This international survey recorded the opinions of multiple sclerosis (MS) nurses about their role in treatment decision making and about the importance of different attributes of autoinjectors used to deliver first-line parenteral therapy. METHODS: The survey involved 52 MS nurses in different practice settings in France, Germany, Italy, the UK, and the USA. Nurses described their role in patient education and in treatment decision making. They also rated the importance of nine prespecified attributes of autoinjectors and stated their preference, both overall and by attribute, for one of two autoinjectors used to deliver interferon β-1b (ExtaviPro(®) 30G and Betacomfort(®)). Nurses’ preferences were compared with those previously collected from patients using an identical questionnaire. RESULTS: There were pronounced differences between practice settings and between countries in the opinions of MS nurses about their influence on treatment decision making. Nurses considered themselves instrumental in helping patients decide between treatment options offered by neurologists. Of the nine autoinjector attributes, nurses rated “reliable to use” as most important, followed by attributes associated with convenience (“easy to operate,” “ergonomic shape,” “reach” [of injection sites], and “one-handed injection”). Nurses’ and patients’ rankings of attributes were closely aligned. For the nine attributes, 74%–98% of nurses preferred ExtaviPro(®) 30G to Betacomfort(®), 94% preferring ExtaviPro(®) 30G overall. Nurses showed a greater preference than patients for ExtaviPro(®) 30G with respect to “easy to operate” (92% vs 78%), “intuitive to use” (98% vs 78%), and “attractive design” (98% vs 83%; P<0.05, all), but preference rates were otherwise similar across the two groups. The most common reasons in both groups for preferring ExtaviPro(®) 30G to Betacomfort(®) were “easy to use” and “ergonomic shape.” CONCLUSION: MS nurses play a key role in patient guidance and education. Their preferences for ExtaviPro(®) 30G likely reflect their understanding of the challenges patients face when self-administering treatment.