PATIENT-REPORTED SATISFACTION ON USTEKINUMAB TREATMENT COMPARED WITH PRIOR BIOLOGIC THERAPY

Purpose: Patient-centered outcomes research may include measures of patient-reported treatment satisfaction. This study estimated patient satisfaction on ustekinumab treatment (UST) compared with prior biologic therapy when used in the treatment of moderate-to-severe plaque psoriasis (PsO).

Method: Patients currently receiving UST through a Specialty Pharmacy Provider (SPP) were administered the abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9), via a cross-sectional Internet survey, to assess satisfaction on UST relative to prior biologic therapy.  Inclusion criteria:  ≥18 years of age, diagnosis of PsO (ICD9 code: 696.1), ≥2 doses of UST between 10/2009-06/2011, and reported previous use of adalimumab or etanercept immediately prior to switching to UST. Time on UST was calculated by subtracting the first shipment date from the survey date, as provided by the SPP.  TSQM-9 includes three satisfaction indices (Global, Effectiveness, and Convenience).  Scores range from 0 to 100 (higher scores reflect better satisfaction).  Differences in treatment satisfaction scores among groups, and as a function of treatment time, were tested with analysis of variance (ANOVA) statistical techniques.

Result: A total of 213 patients completed the survey.  Results were segmented into 4 intervals of time on UST in weeks (n): 7-24 (49), 25-48 (61), 49-72 (76), and 73-83 (27). TSQM-9 Global scores were reported by UST time interval [prior biologic therapy (±SD) vs. UST (±SD), respectively]: 7-24 weeks [42 (±26) vs. 65 (±26)], 25-48 weeks [36 (±24) vs. 69 (±23)], 49-72 weeks [37 (±26) vs. 74 (±20)], and 73-83 weeks [43 (22) vs. 69 (26)].  Similar differences in TSQM-9 scores were reported in favor of UST vs. prior biologic therapy for the medication Effectiveness and Convenience indices.  Differences in satisfaction (±SD) with Effectiveness scores were 19 (±44), 27 (±31), 35 (±31), and 24 (±30), respectively.  Differences in satisfaction (±SD) with Convenience were 8 (±34), 10 (±31), 15 (±25), and 15 (±23), respectively. Improvements in satisfaction between prior treatment and UST were significant for each index, p<0.001.  

Conclusion: Global treatment satisfaction scores, including indices of Effectiveness and Convenience, were higher for patients on UST compared with prior biologic treatment. Patient medication satisfaction is an important element of overall treatment experience.  Further longitudinal research could improve understanding of the impact of UST medication satisfaction on the overall patient experience, and may reduce subjectivity from cross-sectional patient report and recall.