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Impact of Warm Compresses on Local Injection-Site Reactions with Self-Administered Glatiramer Acetate

Jolly, Helen; Simpson, Kellie; Bishop, Barbara; Hunter, Heli; Newell, Cassie; Denney, Douglas; Oleen-Burkey, MerriKay

Journal of Neuroscience Nursing: August 2008 - Volume 40 - Issue 4 - p 232–240
Then & Now

Patients with multiple sclerosis (MS) report a number of adverse events related to immunomodulator injections, including local injection-site reactions (LISRs). Reactions characterized by pain, swelling, redness, or inflammation have been experienced by patients who self-inject glatiramer acetate, interferon beta-1b, or interferon beta-1a. Although these reactions rarely are serious, they can foster negative attitudes about self-injection and undermine a patient's commitment to treatment, especially in the early stages of therapy. This randomized crossover study of 50 patients who had initiated or restarted glatiramer acetate therapy within the 3 months before the study examined whether applying a warm compress to the injection site before self-injection would lower the incidence of LISRs compared with the patients' usual methods of injection preparation. Fewer LISRs were reported both 2 minutes and 5 minutes postinjection when warm compresses were used compared with the usual injection-site preparation (p < .001). Patients also were less bothered by LISRs when using warm compresses, as shown by mean scores on the Bothersome Scale (p = .02). Because warm compresses are easy to apply and appear to be at least modestly effective, they should be considered when recommending alternatives for patients who experience LISRs associated with glatiramer acetate. Warm compresses may be of particular benefit for those who have recently begun therapy with glatiramer acetate to help improve the likelihood of adherence to long-term treatment.

Questions or comments about this article may be directed to MerriKay Oleen-Burkey, PhD, at merrikay.oleenburkey@tevaneuro.com. She is the director of Outcomes Research at Teva Neuroscience, Inc., Kansas City, MO.

Helen Jolly, RN MSCN, is a multiple sclerosis (MS) nurse at the Neurologic Center of South Florida, Miami, FL.

Kellie Simpson, MS NP, is an MS nurse at Fullerton Neurology and Headache Center, Fullerton, CA.

Barbara Bishop, MS ANP-C CNRN, is an MS nurse at Virginia Beach Neurology, Virginia Beach, VA.

Heli Hunter, NP, is an MS nurse at the Advanced Neurosciences Institute, Nashville, TN.

Cassie Newell, MAOM, was the clinical trials manager for the trial at Teva Neuroscience, Inc., Kansas City, MO, that is described in this article. Currently, she is senior clinical project manager for ICON Clinical Research, Lascassas, TN.

Douglas Denney, is a professor in the department of psychology at the University of Kansas-Lawrence.

© 2008 American Association of Neuroscience Nurses