Perceptions on Self-Administration Injections as a Biological Therapy (POSSIBILITY): a multi-country qualitative study of patients with severe asthma

Abstract

Biologicals are a promising treatment for severe eosinophilic asthma. Self-administration by patients of biologicals using an injection pen at home is likely to facilitate their accessibility. However, little is known about patients’ and clinicians’ perceptions and experiences with regard to home administration of biologicals. The Perceptions on Self-Administration Injections as a Biological Therapy (POSSIBILITY) study aims to elucidate these. Methods/Approach A qualitative cross-national study is ongoing in the Netherlands, Northern-Ireland, the United States, and Australia. Per country, two separate Online Focus Groups (OFGs) are held with 6-8 patients, i.e., starters and recent users vs. current users. Prior to the OFGs, patients will be prompted by presenting them with themes on an online forum. OFG discussions will be held using a topic guide to assess a thematic coding tree. Data will be collected iteratively (i.e., updating the topic guide and expanding the thematic coding tree after each OFG). For triangulation purposes, interviews will be held with chest physicians and nurses to discuss salient findings from the OFGs and prescribing decisions. Data will be analyzed with qualitative content analysis. A novel artificial intelligence approach using automated coding of transcripts will be adopted to support the analysis. Results In the Netherlands, the OFGs have been completed. A total of 26 patients responded to the themes on the online forum while 17 participated in the OFGs. Patients used three different brands of home administered biologicals. The topic guide elicited a wide range of experiences and perceptions and the thematic coding tree could be expanded. Salient statements such as “Biologicals are like an intensive rehabilitation treatment in a syringe” also came to the fore. Conclusion These findings are a first step of the unravelling of patient perceptions and experiences with regard to self-administration of biologicals at home.