title: A prospective baseline versus on-treatment study assessing patient perceptions of using a smaller needle when injecting intramuscular interferon beta-1 a (Avonex).
abstract: This study assessed patient perceptions of using a smaller needle (1-inch, 25-gauge) to administer weekly intramuscular (IM) interferon beta-1 a (IFNbeta-1 a [Avonex]) injections. Patients received 1 IM IFNbeta-1 a injection at baseline using the standard needle (1.25-inch, 23-gauge), followed by 4 weekly injections using the smaller needle. The primary end points were change in self-reported visual analog scale scores for preinjection anxiety and postinjection pain, assessed at baseline and once weekly during the 4 weeks of therapy with the smaller needle. Secondary evaluations included assessment of patient perception of ease of use and fear of self-injection with 2 questionnaires, and changes in the number of injection-site reactions. Patients had a mean decrease of 25 +/- 31 mm (baseline mean, 46 mm; 4-week mean, 21 mm; p = .0002) in anxiety score and a mean decrease of 22 +/- 29 mm (baseline mean, 41 mm; 4-week mean, 19 mm; p = .0003) in pain score. Overall, patients thought the smaller needle was easier to use than the standard needle. Qualitative measurements suggested patients who self-injected IM IFNbeta-1 a experienced less fear when using the smaller needle. Preinjection preparation parameters decreased throughout the course of the treatment period. No patients experienced injection-site reactions with the smaller needle. Patients preferred using a smaller needle to administer their weekly IM IFNbeta-1 a injection.
authors.affiliation: University of North Carolina, Chapel Hill NC, USA. smfreedman@aol.com
authors.forename: S Mitchell
authors.initials: SM
authors.lastname: Freedman
authors.forename: Darcy
authors.initials: D
authors.lastname: Cox
authors.forename: Teresa
authors.initials: T
authors.lastname: Rosebrough
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D001294:Attitude to Health; D004867:Equipment Design; D005239:Fear; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000295:instrumentation* / Q000523:psychology; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage*; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000451:nursing / Q000523:psychology; D009339:Needles / Q000009:adverse effects; D015404:Nursing Methodology Research; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement; D011446:Prospective Studies; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012646:Self Administration / Q000009:adverse effects / Q000295:instrumentation* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D000068556:Interferon beta-1a