title: Self-injection anxiety training: a treatment for patients unable to self-inject injectable medications.
abstract: Anxiety and phobia frequently prevent patients with multiple sclerosis (MS) from self-injecting their injectable disease-modifying medications. This small, randomized, controlled trial tested the efficacy of a six-session nurse-administered programme to teach self-injection to patients with MS, who, due to anxiety or phobia, were unable to self-inject their injectable medications. Participants were 30 patients with MS who were prescribed interferon beta-1a (IFNbeta-1a) administered via weekly intramuscular injection. All patients were unable to self-inject due to anxiety or phobia. Patients were randomized to either the six-session Self-Injection Anxiety Therapy (SIAT) or a control telephone support condition modelled on the support programme offered by the manufacturer of IFNbeta-1a. Four patients dropped out of SIAT while three dropped out of the control condition. Eight patients receiving SLAT compared to three control patients, were able to self-inject after six weeks of treatment. SIAT patients were significantly more likely to achieve self-injection at treatment cessation, compared to telephone control patients, in completer analyses (p =0.022), however, this only reached a trend in intent-to-treat analyses (p =0.058). These findings suggest that SIAT is a potentially valuable intervention to teach self-injection skills to injection phobic and anxious patients, and should be investigated more thoroughly in a larger clinical trial.
authors.affiliation: University of California, San Francisco, CA, USA. dmohr@itsa.ucsf.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Mohr
authors.forename: Darcy
authors.initials: D
authors.lastname: Cox
authors.forename: Natalia
authors.initials: N
authors.lastname: Merluzzi
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods / Q000451:nursing / Q000523:psychology*; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000451:nursing / Q000523:psychology; D010698:Phobic Disorders / Q000451:nursing / Q000523:psychology; D012646:Self Administration / Q000379:methods / Q000451:nursing / Q000523:psychology
chemical_list: D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D000068556:Interferon beta-1a