Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.
BACKGROUND
Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies.


METHODS
A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires.


RESULTS
A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches.


CONCLUSIONS
The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence.
Servicio de Neurología, Hospital Clínic i provincial de Barcelona, Universitat de Barcelona e Institut d́Investigació August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address: asaiz@clinic.ub.es.
A
A
Saiz
Departamento Médico, Novartis Farmacéutica S.A., Barcelona, España.
S
S
Mora
Departamento Médico, Novartis Farmacéutica S.A., Barcelona, España.
J
J
Blanco
D000328:Adult; D017668:Age of Onset; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D016899:Interferon-beta / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires
D016899:Interferon-beta
Acetato de glatirámero; Calidad de vida; Compliance; Cumplimiento; Esclerosis múltiple; Glatiramer acetate; Interferon beta; Interferón beta; Multiple sclerosis; Quality of life; Satisfacción; Satisfaction