Supplementary materials: Patient-reported preferences for subcutaneous or intravenous administration of parenteral drug treatments in adults with immune disorders: a systematic review and meta-analysis

<b>These are peer-reviewed supplementary materials for the article '</b><b>Patient-reported preferences for </b><b>subcutaneous or intravenous </b><b>administration of parenteral drug </b><b>treatments in adults with immune </b><b>disorders: a systematic review and </b><b>meta-analysis</b><b>' published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Supplementary Figure </b><b>1</b><b>:</b> Meta-analysis of patient preferences for home versus hospital treatment.<b>Supplementary Figure </b><b>2</b><b>:</b> LQI 4-scale scores.<b>Supplementary Figure </b><b>3</b><b>:</b> SF-36 PCS and MCS results.<b>Supplementary Table 1:</b> PubMed search terms<b>Supplementary Table 2:</b> PICOS table summarizing inclusion/exclusion criteria<b>Supplementary Table 3:</b> Treatment satisfaction results, TSQM and rating scales<b>Aim:</b> Several studies have found subcutaneous (SC) and intravenous (IV) administration of similar drugs for long-lasting immunological and autoimmune diseases to have similar clinical effectiveness, meaning that what patients report they prefer is, or should be, a major factor in treatment choices. Therefore, it is important to systematically compile evidence regarding patient preferences, treatment satisfaction and health-related quality of life (HRQL) using SC or IV administration of the same drug. <b>Materials &amp; methods:</b> PubMed database searches were run on 15 October 2021. Studies involving patients with experience of both home-based SC and hospital-based IV administration of immunoglobulins or biological therapies for the treatment of any autoimmune disease or primary immunodeficiencies (PIDs) were included. The outcomes assessed were patient preferences, treatment satisfaction and HRQL. Preference data were meta-analyzed using a random-effects model.<b> Results:</b> In total, 3504 citations were screened, and 46 publications describing 37 studies were included in the review. There was a strong overall preference for SC over IV administration, with similar results seen for PIDs and autoimmune diseases: PID, 80% (95% confidence interval [CI], 64–94%) preferred SC; autoimmune diseases, 83% (95% CI: 73–92%); overall, 82% (95% CI: 75–89%). The meta-analysis also found that 84% (95% CI: 75–92%) of patients preferred administration at home to treatment in hospital. Analysis of treatment satisfaction using the life quality index found consistently better treatment interference and treatment setting scores with SC administration than with IV administration. Conclusion: Compared with IV infusions in hospital, patients tend to prefer, to be more satisfied with and to report better HRQL with SC administration of the same drug at home, primarily due to the greater convenience. This study contributes to evidence-based care of patients with autoimmune diseases or PIDs.

本文件为发表于《比较疗效研究杂志》（*Journal of Comparative Effectiveness Research*）的论文《免疫疾病成人患者皮下注射或静脉注射胃肠外药物治疗的患者报告偏好：系统评价与荟萃分析》的同行评议补充材料。
补充图1：患者对居家与院内治疗偏好的荟萃分析
补充图2：生活质量指数（Life Quality Index, LQI）4分量表得分
补充图3：SF-36躯体健康总评（PCS）与精神健康总评（MCS）结果
补充表1：PubMed检索式
补充表2：总结纳入与排除标准的PICOS表
补充表3：治疗满意度结果、治疗满意度调查问卷（Treatment Satisfaction Questionnaire for Medication, TSQM）与评分量表

研究目的：已有多项研究证实，针对慢性免疫性与自身免疫性疾病的同类药物，皮下注射（subcutaneous, SC）与静脉注射（intravenous, IV）的临床疗效相当，这意味着患者的报告偏好是乃至应当成为治疗选择的核心决策因素。因此，系统整合关于同类药物采用皮下或静脉注射时的患者偏好、治疗满意度与健康相关生活质量（Health-Related Quality of Life, HRQL）的相关证据具有重要意义。

材料与方法：本研究于2021年10月15日检索PubMed数据库。纳入的研究需针对自身免疫性疾病或原发性免疫缺陷病（Primary Immunodeficiencies, PIDs）患者，且受试者需同时具备居家皮下注射与院内静脉注射免疫球蛋白或生物制剂的给药体验。本研究的评估结局包括患者偏好、治疗满意度与HRQL。偏好数据采用随机效应模型进行荟萃分析。

研究结果：本研究共筛选3504条引文，最终纳入46项已发表研究（涵盖37项独立研究）。整体而言，患者对皮下注射的偏好显著高于静脉注射，原发性免疫缺陷病与自身免疫性疾病亚组结果一致：原发性免疫缺陷病患者中80%（95%置信区间[CI]：64%~94%）偏好皮下注射；自身免疫性疾病患者中83%（95% CI：73%~92%）偏好皮下注射；整体人群中这一比例为82%（95% CI：75%~89%）。荟萃分析同时显示，84%（95% CI：75%~92%）的患者更偏好居家给药而非院内治疗。基于生活质量指数的治疗满意度分析表明，皮下注射组的治疗干扰评分与治疗环境评分均显著优于静脉注射组。

研究结论：与院内静脉输注相比，患者更倾向于选择居家皮下注射同类药物，且对该给药方式的满意度更高、健康相关生活质量报告更佳，这主要源于其更高的便捷性。本研究可为自身免疫性疾病或原发性免疫缺陷病患者的循证诊疗提供证据支持。