A SYSTEMATIC REVIEW OF STUDIES INVESTIGATING THE EFFECTIVENESS OF ADALIMUMAB PATIENT SUPPORT PROGRAMMES

Background: Adalimumab patient support programmes (A-PSPs) are offered to patients with chronic inflammatory indications creating the need to study how such A-PSPs assist patients and other stakeholders in improving health outcomes. A deeper understanding of the effects of A-PSPs can improve treatment outcomes and experience of patients being treated with adalimumab. Objectives: To review current studies evaluating A-PSPs, summarize their general characteristics and methodology, and recommend future research work in the area of A-PSPs. Methods: Studies were identified through Web of Science and were cross-checked by searching through PubMed and MEDLINE databases, following PRISMA guidelines. Full-text papers and conference proceedings identified by the database search were reviewed for relevance. Results: 17 studies evaluating the impacts of A-PSPs on patient outcomes were identified – 6 full-text articles and 11 meeting abstracts. Most research was done at the international level or in North America [1-3]. In only 5 reviewed studies a prospective study design was applied. Indications most commonly investigated were rheumatoid arthritis and inflammatory bowel disease. 12 studies evaluated the impact of all interventions of A-PSPs while others assessed the impact of Coach Care Calls or phone calls. Patient outcomes most commonly measured were persistence, adherence and low disease activity or remission. Overall, patients using any of the interventions of A-PSPs experienced significantly better improvements in all studied patient outcomes at different follow-up assessments compared to those not enrolled into any of the programme’s interventions. Study population sizes and ratios between assigned users and non-users of interventions differed between studies. The most frequent follow-up assessments were after 12 and 24 months of treatment with adalimumab. Data for analysis was mostly obtained by linking a patient support database and claims administrative database, and in 5 cases by applying patient and physician reported surveys. Methodology for assessing the differences between users and non-users of interventions of A-PSPs consisted of univariate and multivariate methods, where the causal relationships between the impact of patient support program and patient outcomes were estimated by regression modelling adjusted for multiple confounders. Conclusion: Interventions of A-PSPs have been shown to have a positive impact on all investigated patient outcomes. Main recommendations for future studies are to design a prospective study, include persistence and adherence measures in the study design, and to assess patient outcomes with additional measures such as patient outcomes based on a patient-centric approach and adverse effects. Disclosure of interest: This literature review was funded by AbbVie Inc. REFERENCES: [1] Van den Bosch F, Ostor AJK, Wassenberg S, Chen NJ, Wang C, Garg V, Kalabic J. 2017. Impact of participation in the adalimumab (Humira) patient support program on rheumatoid arthritis treatment course: results from the PASSION study. Rheumatol Ther, 4(1): 85-96 [2] Marshall JK, Bessette L, Thorne C, Shear NH, Lebovic G, Gerega SK, Millson B, Oraichi D, Gaetano T, Gazel S, Latour MG, Laliberté MC. 2018. Impact of the adalimumab patient support program’s care coach calls on persistence and adherence in Canada: an observational retrospective cohort study. Clin Ther, 40(3): 415-429 [3] Rubin DT, Mittal M, Davis M, Johnson S, Chao J, Skup M. 2017. Impact of a patient support program on patient adherence to adalimumab and direct medical costs in Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriasis, psoriatic arthritis, and ankylosing spondylitis. J Manag Care Spec Pharm, 23(8): 859-867 Disclosure of Interests: None declared DOI: 10.1136/annrheumdis-2019-eular.6258Citation: Ann Rheum Dis, volume 78, supplement 2, year 2019, page A2073Session: Public health, health services research, and health economics (Scientific Abstracts)