title: Addressing the need for increased adherence to multiple sclerosis therapy: can delivery technology enhance patient motivation?
abstract: BACKGROUND
  Several injectable disease-modifying drugs are available for the treatment of multiple sclerosis (MS) to control disease progression and reduce relapse frequency and severity. However, the benefits offered by treatment may be compromised by suboptimal levels of adherence to prescribed regimens.
  
  
  OBJECTIVE
  To examine what is now known about adherence to MS therapies, and to discuss how technological advances may affect adherence in the future, with reference to examples from other therapy areas.
  
  
  RESULTS
  Perceived lack of efficacy and therapy-related adverse events are important factors influencing poor adherence. Comprehensive patient education and support are vital in maintaining adherence to MS therapies. Also, improvements in the tolerability, convenience of administration and patient acceptability of MS therapies may enhance adherence. This may be achieved by adjustments to drug formulation and the use of injection devices. Auto-injector devices have been shown to reduce the incidence of injection-site reactions and discomfort in patients with MS, and it is hoped that improvements in delivery technology may further enhance patient motivation to remain adherent to MS therapy in the future. The most recent advance in injection-delivery technology is the development of electronic devices, which can be adjusted for comfort and record dosing history.
  
  
  CONCLUSIONS
  Few studies have directly addressed adherence to MS therapy and further clarification is required. Adjustments to drug formulation, provision of patient education and improvements to injection devices may all contribute indirectly to improved adherence in the future.
authors.affiliation: University Gabriele d'Annunzio of Chieti-Pescara, Ospedale Clinicizzato Santissima Annunziata, c/o Centro Sclerosi multipla (VII livello, corpo A), Department of Oncology and Neuroscience, Chieti, Italy. a.lugaresi@unich.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lugaresi
mesh_terms: D018450:Disease Progression; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007267:Injections; D055118:Medication Adherence; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010353:Patient Education as Topic; D012720:Severity of Illness Index; D013678:Technology, Pharmaceutical / Q000379:methods
chemical_list: D007155:Immunologic Factors