Usability of an application device for nabiximols oromucosal spray in patients with upper limb impaired multiple sclerosis

Aim: This study aimed to assess the usability of a specific EU-available application device for Sativex " (USA adopted name: nabiximols) cannabinoid-based oromucosal spray in patients with multiple sclerosis (MS) and spasticity-related upper limb and hand impairment in routine daily practice. Methods: MS patients with upper limb and hand impairment evaluated the usability of the device using an ad hoc 18-item questionnaire. Results: 60 patients were included. The comprehensibility of the instructions for use, practical handling and ergonomics of the device were rated as optimal (mean scores >= 8.9/10 across questions). Assisting trained nurses also rated the device as easy to use and helpful for drug administration (mean scores 10/10). Conclusion: The application device may assist MS patients with upper limb impairment self-administer nabiximols oromucosal spray.Plain language summary: Many patients with multiple sclerosis lose some function in their upper limbs (arms) and hands because of spasticity, which can make it difficult to take their medication at the required times each day. Patients taking nabiximols oromucosal spray may not have the strength or coordination needed to press the spray nozzle into their mouth. To support delivery of the medicine in these patients, a specific application device has been developed that reduces the strength necessary to administer the spray. 60 patients with upper limb/hand impairment tested the device and completed an 18-item questionnaire. Patients rated the instructions for use, ease of use and ergonomic features of the device as optimal, with average scores of >= 8.9/10 across questions.