Factors that influence adherence with disease-modifying therapy in MS.
BACKGROUND
The complexity and cost of injection treatment can represent a formidable challenge for patients affected by a chronic illness, particularly those whose treatment is primarily preventative and only modestly effective on the more conspicuous symptomatic aspects of the disease process. The aim of this investigation was to identify which factors most influenced nonadherent behavior with the available disease-modifying injection therapies for multiple sclerosis (MS).


METHODS
A multicenter, observational (three-wave) study using surveys was developed and administered to patients with MS through the World Wide Web. Healthcare providers at 17 neurology clinics recruited patients for the study.


RESULTS
A total of 798 patients responded to the baseline wave of the study (708 responded to all three waves). The nonadherence rates for all patients (missing one or more injections) across these waves remained relatively stable at 39%, 37%, and 36%, respectively. The most common reason participants listed for missing injections was that they simply forgot to administer the medication (58%). Other factors including injection-site reactions, quality of life, patients' perceptions on the injectable medications, hope, depression, and support were also assessed in relation to adherence.


CONCLUSIONS
This study characterizes factors that are associated with failure to fully adhere with disease modifying injection therapy for MS and underscores the principles associated with optimizing adherence and its implications for effective treatment of the disease process in MS.
Treadaway
Katherine
K
Dept. of Neurology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235, USA.
Cutter
Gary
G
Salter
Amber
A
Lynch
Sharon
S
Simsarian
James
J
Corboy
John
J
Jeffery
Douglas
D
Cohen
Bruce
B
Mankowski
Ken
K
Guarnaccia
Joseph
J
Schaeffer
Lawrence
L
Kanter
Roy
R
Brandes
David
D
Kaufman
Charles
C
Duncan
David
D
Marder
Ellen
E
Allen
Arthur
A
Harney
John
J
Cooper
Joanna
J
Woo
Douglas
D
Stüve
Olaf
O
Racke
Michael
M
Frohman
Elliot M
EM
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000704:Analysis of Variance; D003863:Depression; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007267:Injections / Q000523:psychology; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000523:psychology*; D018696:Neuroprotective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires
D018696:Neuroprotective Agents