title: [Therapy adherence to immunomodulator treatment in patients with multiple sclerosis].
abstract: BACKGROUND
  Immunomodulator treatment modifies the course of the disease in patients with multiple sclerosis. The patient's adequate adherence with the treatment regimen is absolutely essential.
  
  
  OBJECTIVE
  To determine the real adherence with first-line immunomodulator treatment and to try to find out what factors may influence adequate adherence with the treatment.
  
  
  METHODS
  We conducted an observation-based, retrospective, longitudinal study of the patients being followed up by the Centre d'Esclerosi Multiple de Catalunya at the Hospital Universitari Vall d'Hebron that were given first-line immunomodulator treatment (interferons or glatiramer acetate) between 1st January 2010 and 30th September 2011. Adherence was measured using the medication possession ratio (MPR): patients with an MPR above or equal to 80% were considered to be compliers.
  
  
  RESULTS
  We studied 975 patients. The mean time of exposure to immunomodulators over the collected period was 13.4 ± 7.1 years. Altogether 85.2% of patients complied with the immunomodulator treatment adequately. Of a total of 975 patients treated, 134 needed to change to a second drug and 12 patients had to go on to a third. Changing the medication improved adherence (p = 0.001). The annual rate of attacks was 0.23. Only the presence of attacks (p = 0.029) and the drug used (p = 0.044) had any influence on treatment adherence, on an individual basis.
  
  
  CONCLUSIONS
  The percentage of patients with adequate treatment adherence in our centre is high. The rate of attacks and the drug used play a decisive role. Close monitoring and personalised counselling are required to maintain good therapeutic adherence.
authors.affiliation: Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Espana.
authors.forename: Pino
authors.initials: P
authors.lastname: López-Méndez
authors.forename: Jordi
authors.initials: J
authors.lastname: Río
authors.forename: Ariadna
authors.initials: A
authors.lastname: Pérez-Ricart
authors.forename: Mar
authors.initials: M
authors.lastname: Tintoré
authors.forename: Jaume
authors.initials: J
authors.lastname: Sastre-Garriga
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cardona-Pascual
authors.forename: M Rosa
authors.initials: MR
authors.lastname: Gómez-Domingo
authors.forename: Xavier
authors.initials: X
authors.lastname: Montalban
mesh_terms: D000328:Adult; D003376:Counseling; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000523:psychology; D010455:Peptides / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D007155:Immunologic Factors; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a