title: Therapeutic expectations of patients with multiple sclerosis upon initiating interferon beta-1b: relationship to adherence to treatment.
abstract: This study, conducted in three separate outpatient health care delivery settings, examined the therapeutic expectations of patients with multiple sclerosis (MS) before they initiated interferon beta-1b therapy, the results of current educational procedures to correct unrealistic expectations, and the relationship between post-education expectations and discontinuing therapy. Ninety-nine consecutive patients were seen in a university based outpatient MS clinic, an academic group practice outpatient MS clinic, or a health maintenance organization outpatient neurology clinic. Before the educational sessions, 57% of the patients expressed unrealistically optimistic expectations regarding reduction in attack rate and 34% expressed unrealistically optimistic expectations regarding improvement in functional status. Educational procedures significantly altered unrealistic expectations but the results were sub-optimal since 33% of the patients maintained overly optimistic expectations regarding reduction in attack rate. Post-education unrealistic expectations of improvement in functional status were significantly related to discontinuing therapy within 6 months. Three adverse effects of therapy also were related independently to adherence to treatment: depression and flu-like symptoms were related to discontinuing therapy while soreness at injection site was related to continuing therapy.
authors.affiliation: University of California, San Francisco, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Mohr
authors.forename: D E
authors.initials: DE
authors.lastname: Goodkin
authors.forename: W
authors.initials: W
authors.lastname: Likosky
authors.forename: N
authors.initials: N
authors.lastname: Gatto
authors.forename: L K
authors.initials: LK
authors.lastname: Neilley
authors.forename: C
authors.initials: C
authors.lastname: Griffin
authors.forename: B
authors.initials: B
authors.lastname: Stiebling
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001294:Attitude to Health; D005260:Female; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009103:Multiple Sclerosis / Q000628:therapy*; D010349:Patient Compliance; D010352:Patient Dropouts; D010353:Patient Education as Topic
chemical_list: D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b; D016899:Interferon-beta; D000068556:Interferon beta-1a