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Tuesday, September 12, 2006
IMPORTANT
Managing Self-Injection Difficulties in Patients With Relapsing- Remitting MS [CLICK TO READ THE FULL ARTICLE]
University of California, San Francisco (UCSF) MS Center
"At UCSF, we developed a six-session cognitivebehavioral treatment for self-injection anxiety. This model has been tested and found to be effective when either psychologists or nurses are providers. The trials have been described elsewhere (Cox, Mohr, & Epstein, 2004; Mohr, Cox, Epstein, & Bondewyn, 2002, 2005)....
It is important to remember that, for some patients, anxiety can increase the experience of pain.....
All pharmaceutical companies that market injectable medications for MS provide injection-training services through home health nurses. The quality of these services varies a great deal, and patients may have received incomplete or inaccurate information during training. We encourage these companies to continue to improve their services but also recognize the difficulties associated with providing services nationwide. We acknowledge that nurses who serve MS patients must also educate patients.
Multiple factors can contribute to the inability to self-inject. Many patients are misinformed about the risks of self-injection and believe it to be unsafe or even potentially life-threatening. Others are misinformed about how best to manage injection pain and side effects. ...
We also found that many patients have distorted beliefs about the injection and the meaning of the injection in their lives. Specifically, patients begin to consider the injection to be a burden associated with their disease, rather than the way to best manage their disease. For these patients, disconnecting the experience of the injection from the experience of living with MS is often necessary to allow self-injection.
Almost all patients with self-injection difficulties reported some feeling or belief that self-injecting means "I really have MS" or "I'm allowing the MS greater control of my life."
Many adults can receive injections administered by others with minimal difficulty and discomfort, but they experience significant levels of anxiety if they are required to self-inject. This anxiety poses a barrier to treatment for multiple sclerosis (MS), because the patient becomes dependent on others to administer injections. Self-injection allows the patient maximum independence and reduces the risk of missed injections or drug discontinuation due to unreliable injection assistance......
Summary
Self-injection anxiety is a fairly common problem among patients with MS. Fortunately, self-injection anxiety can be reduced with brief treatment in most cases. The treatment strategies we have developed have been validated in a number of small clinical trials (Cox et al., 2004; Mohr et al., 2002, 2005) and are available online without charge to both patients and their providers.
The clinicians at the UCSF MS Center who have provided treatment for self-injection anxiety have found it to be a particularly rewarding clinical activity. We enjoy celebrating patient successes and helping patients learn to inject with confidence rather than experience fear and failure."
University of California, San Francisco (UCSF) MS Center
"At UCSF, we developed a six-session cognitivebehavioral treatment for self-injection anxiety. This model has been tested and found to be effective when either psychologists or nurses are providers. The trials have been described elsewhere (Cox, Mohr, & Epstein, 2004; Mohr, Cox, Epstein, & Bondewyn, 2002, 2005)....
It is important to remember that, for some patients, anxiety can increase the experience of pain.....
All pharmaceutical companies that market injectable medications for MS provide injection-training services through home health nurses. The quality of these services varies a great deal, and patients may have received incomplete or inaccurate information during training. We encourage these companies to continue to improve their services but also recognize the difficulties associated with providing services nationwide. We acknowledge that nurses who serve MS patients must also educate patients.
Multiple factors can contribute to the inability to self-inject. Many patients are misinformed about the risks of self-injection and believe it to be unsafe or even potentially life-threatening. Others are misinformed about how best to manage injection pain and side effects. ...
We also found that many patients have distorted beliefs about the injection and the meaning of the injection in their lives. Specifically, patients begin to consider the injection to be a burden associated with their disease, rather than the way to best manage their disease. For these patients, disconnecting the experience of the injection from the experience of living with MS is often necessary to allow self-injection.
Almost all patients with self-injection difficulties reported some feeling or belief that self-injecting means "I really have MS" or "I'm allowing the MS greater control of my life."
Many adults can receive injections administered by others with minimal difficulty and discomfort, but they experience significant levels of anxiety if they are required to self-inject. This anxiety poses a barrier to treatment for multiple sclerosis (MS), because the patient becomes dependent on others to administer injections. Self-injection allows the patient maximum independence and reduces the risk of missed injections or drug discontinuation due to unreliable injection assistance......
Summary
Self-injection anxiety is a fairly common problem among patients with MS. Fortunately, self-injection anxiety can be reduced with brief treatment in most cases. The treatment strategies we have developed have been validated in a number of small clinical trials (Cox et al., 2004; Mohr et al., 2002, 2005) and are available online without charge to both patients and their providers.
The clinicians at the UCSF MS Center who have provided treatment for self-injection anxiety have found it to be a particularly rewarding clinical activity. We enjoy celebrating patient successes and helping patients learn to inject with confidence rather than experience fear and failure."