title: [Proposals to improve adherence to immunomodulatory therapies in patients with multiple sclerosis].
abstract: BACKGROUND
  The objective of this work was to assess the factors identified in the Global Adherence Project (GAP) in disease-modifying therapy (DMT) in patients with multiple sclerosis (MS) and to propose measures directed at improving adherence. It was proposed to prepare questionnaires to detect patients at risk of non-adherence before and during the follow-up.
  
  
  METHODS
  Two meetings were held by Spanish researchers involved in the GAP project. Factors associated with non-adherence were grouped in therapy-, patient-, disease- and health care professional-related factors. Four working groups were created. Each group studied one individual,factor, taking into account the stages of diagnosis, management and administering treatment, follow-up and discontinuation or change of treatment. A draft of proposals and tools (questionnaires) was agreed.
  
  
  RESULTS
  Patients should be provided with summaries of treatments, in a positive and simple way, and have time to discuss any doubts. Questionnaires should be given to patients at the start of treatment and during follow-up, so that individual characteristics can be assessed in order to monitor their adherence and act accordingly. Patients should be instructed in the management of the most common adverse reactions.
  
  
  CONCLUSIONS
  Therapeutic education to improve adherence to treatments and identification of non-adherent patients is recommended. We propose 2 questionnaires, initial and follow up, to stratify patients depending on their adherence.
authors.affiliation: Departamento Médico de Biogen Idec Iberia, S.L., Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Arroyo
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: C
authors.initials: C
authors.lastname: Grau
authors.forename: C
authors.initials: C
authors.lastname: Arnal
authors.forename: M
authors.initials: M
authors.lastname: Bujanda
authors.forename: P
authors.initials: P
authors.lastname: de Castro
authors.forename: L
authors.initials: L
authors.lastname: Grau
authors.forename: M
authors.initials: M
authors.lastname: Martínez
authors.forename: C
authors.initials: C
authors.lastname: Ramo
authors.forename: V
authors.initials: V
authors.lastname: Sánchez
authors.forename: O
authors.initials: O
authors.lastname: Sánchez-Soliño
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D056747:Immunomodulation; D009103:Multiple Sclerosis / Q000188:drug therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires