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Mode of injection and treatment adherence: results of a survey characterizing the perspectives of health care providers and US women 18–45 years old

Authors Gandell DL, Bienen EJ, Gudeman J

Received 11 September 2018

Accepted for publication 18 January 2019

Published 22 February 2019 Volume 2019:13 Pages 351—361


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

David L Gandell,1 E Jay Bienen,2 Jennifer Gudeman3

1Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA; 2The Curry Rockefeller Group, Tarrytown, NY, USA; 3Medical Affairs, AMAG Pharmaceuticals Inc., Waltham, MA, USA

Purpose: A market research study was conducted to characterize perceptions of intramuscular (IM) and subcutaneous (SC) routes of injection, including use of autoinjectors, and how these perceptions affect adherence to injection regimens. The perspectives were from women of childbearing age (18–45 years old; consumers) and health care providers (HCPs) involved in women’s health care.
Methods: Two telephone surveys, one of HCPs and the other of consumers, were conducted by KRC Research (New York, NY, USA) between May and July 2017. HCPs were recruited across the US; the consumer survey was administered to a nationally representative sample. Survey questions identified potential challenges of IM and SC administration, their impact on treatment adherence, and perceptions of autoinjectors. Results are reported using descriptive statistics and reflect an unweighted sample; margin of error is ±3% for the consumer survey.
Results: HCP respondents included 100 generalist OB/GYNs, 101 maternal-fetal medicine specialists, and 519 nurses; there were 1,012 female consumer respondents. Nurses reported more experience than physicians in administering injections, including with autoinjectors. Consumers reported having received treatments via both IM and SC injections; 26% had received treatment with injections at regular intervals. Most HCPs (58%) said they preferred to administer SC injections, which was also the preference for receiving injections among consumers, who reported needle size as a concern regardless of administration mode. Other major concerns were perceptions of pain and fear/anxiety, and seeing the needle, all of which were greater for IM than for SC injections. HCPs and consumers both reported greater likelihood of adherence to therapy administered SC using an autoinjector because they believe that this method provides substantial HCP and patient benefits.
Conclusion: HCPs and consumers identified similar challenges with adherence to injections. However, there was consistently higher preference for SC relative to IM. HCPs and consumers believe that autoinjectors may increase adherence.

Keywords: women’s health care, intramuscular, subcutaneous, injection, patient preference, adherence

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