title: Predicting treatment discontinuation among patients with multiple sclerosis: application of the transtheoretical model of change.
abstract: OBJECTIVE
  To delineate factors associated with discontinued use of the multiple sclerosis (MS) medication Avonex (interferon beta-1a--Biogen) as part of an effort to develop an intervention to promote treatment persistency.
  
  
  METHODS
  In-depth telephone interviews followed by a 12-page written questionnaire delivered by mail.
  
  
  METHODS
  United States.
  
  
  METHODS
  Of 946 patients with MS who were contacted, 531 (56%) completed questionnaires; 79% of respondents were currently using Avonex for treatment of MS.
  
  
  METHODS
  Discontinuation of Avonex treatment, with analysis based on the theoretical framework of the Transtheoretical Model of Change.
  
  
  RESULTS
  Four key variables (pros of Avonex use, cons of Avonex use, highest level of education completed, and level of disability) accurately identified 82% of patients who discontinued Avonex use, while also correctly identifying 81% of patients who stayed on the drug.
  
  
  CONCLUSIONS
  Constructs from the Transtheoretical Model of Change were effective in differentiating patients who had discontinued their Avonex treatment versus patients who continued treatment. This behavioral model likely would be an effective framework for a medication persistency intervention.
authors.affiliation: Pharmacy Care Systems, 128 Miller Hall, Auburn University, AL 36849-5506, USA. bergeba@mail.auburn.edu
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Berger
authors.forename: Karen Suchanek
authors.initials: KS
authors.lastname: Hudmon
authors.forename: Huigang
authors.initials: H
authors.lastname: Liang
mesh_terms: D001294:Attitude to Health; D003657:Decision Making; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D011582:Psychological Theory; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D016899:Interferon-beta; D000068556:Interferon beta-1a