Gain without the pain

New technology is improving treatment options for those living with multiple sclerosis, writes Annie May.

For the 18,000 Australians living with multiple sclerosis, up until now, treatment options often came in the form of regular painful injections. Problems with self injection pose particular barriers to treatment adherence for many patients.

However, new technology is providing hope of greater comfort during treatment with the first electronic injection device, RebiSmart, approved for use in Australia.

Developed to provide greater ease and comfort to patients who rely on injections to treat and delay the debilitating effects of the disease, it is already making a positive impact on the lives of Australians.

“No one likes having injections, especially when they have to do it themselves,” says Jennifer Coleman, clinical nurse consultant (MS) at Melbourne’s Austin Hospital.

“Some people may be needle-phobic, which adds to the anxiety, while others don’t have the dexterity so have to rely on someone else. Adherence is a major problem.

An MS specialist nurse for 15 years, Coleman saw the introduction of disease modification for MS and has witnessed many of her patients struggle with injections.

Research has shown that while many adults can receive injections administered by others with minimal difficulty and discomfort, they experience significant levels of anxiety if they are required to self-inject.

This anxiety poses a barrier to treatment, because the patient becomes dependent on others to administer injections. A device such as RebiSmart empowers patients by making the process of self-injection less difficult, painful – and confronting, says Coleman.

Simple to use, the electronic injector – used to deliver the new multidose presentation of Rebif – has an electronic screen that guides patients through the three step process with text and pictures.

It allows the patient to personalize their injections by selecting their preferred needle speed, depth and timing. A green light and a beep alerts them to the completion of the process. It holds one weeks worth of treatment and allows patients to check their dosage history, including date and time of every injection, on the device handset.

But perhaps its best feature is that it doesn’t look like an injector and, according to some of Coleman’s patients, doesn’t feel like an injection.

“It looks a lot like a mobile phone, which goes a long way to easing anxiety and also lessens the stigma attached to injections,” she says.

The needle is hidden from view throughout the process, and only injects when the device is safely against the patient’s skin.

“This takes away the urgh factor, and people who used to rely on others are doing it themselves.”

Greater independence is one of the benefits Coleman has seen from her patients using RebiSmart.

This was the case with one who only had the use of one hand. This meant he struggled with self-injection and had to rely on others for his medication. That has changed and he can now do it by himself. “He has his independence back and he won’t give it back,” says Coleman.

Another benefit is reducing the risk of missed injections or drug discontinuation.

“RebiSmart keeps track of injections and will also let you know if an injection was started but not completed. Before, this needed to be physically marked on a calendar, which is not effective,” says Coleman.

“MS can impact on memory, but everyone can forget and be distracted. Putting measures into place to not depend on an individual enhances adherence, and that is a great thing.”

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