Objective:

To evaluate neurologists’ perception of PD patient attitudes towards injectable therapies and determine if education on these attitudes would alter neurologists’ willingness to prescribe these therapies.

Background:

OFF episodes occur in majority of PD patients negatively impacting their day-to-day life. Subcutaneous injections of apomorphine have been shown to reduce OFF episodes with a rapid onset of action. Several other products are currently in development for the treatment of motor fluctuations requiring continuous subcutaneous infusion.  We had previously reported that 89% of patients would be willing to self-inject, when there is an associated benefit. We hypothesized the following: 1.  neurologists were unaware of this information (overestimating the impact of “needle phobia”) and as a result may underutilize these effective therapies.  2.  neurologists’ willingness to prescribe injectable therapies would increase after learning this information. 

Design/Methods:

Data were collected using an online survey. Our sample (n=200) comprised n=115 Movement Disorder Specialists (MDS) and n=85 General Neurologists. The sample had n=96 physicians who had previously prescribed APOKYN® and n=104 who had not.

Results:

54% of general neurologists and 37% of MDS demonstrated a positive change in perceptions about patients’ willingness to use self-injected therapies after reviewing patient survey data (all P<0.05).  This was true amongst 53% of APOKYN® non-users and 35% of APOKYN®  users (all P<0.05).    In addition, 37% of general neurologists and 21% of MDS indicated a greater likelihood of prescribing these treatments (all P< 0.05).

Conclusions:

Neurologists may be overestimating the impact of “needle phobia" since there is a discrepancy between PD patients’ willingness to self-inject medications and neurologists’ perceptions.    Educating neurologists about actual patient acceptance of injectable therapies appeared effective, might facilitate more discussions about injectable therapies with patients who have troublesome off time, and may result in greater utilization of these effective therapies.