多発性硬化症におけるインターフェロンβ-1b療法の外来導入の実際

概要

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Interferon (IFN) β-1b is the only drug available in Japan that is used to prevent relapse and progression of multiple sclerosis (MS). When treatment is started, patient education and side effect management are needed, and for that reason, patients are preferably hospitalized. However, MS often occurs among young persons and they usually have difficulty finding time for hospitalization. Therefore, establishing an effective outpatient introduction system is needed. We first confirmed the efficacy and safety of a gradual dose titration of IFN β-1b on an inpatient basis to 14 patients. We found that skin problems were among the most common side effects and these problems could be reduced by teaching the patients the injection technique again or introducing self-monitoring injection assistance apparatus. We then implemented the same protocol and critical path to 7 outpatients. Selfmonitoring injection could be successfully done by the patients after 5 instructions by a nurse. Except one patient who developed hepatopathy, all others had mild side effects. Abnormalities were detected early, and all had high satisfaction levels. We conclude that a successful outpatient IFN β-1b educational program requires positive joint interventions by nurses and physicians, and practical use of critical path.
東京女子医科大学の論文