Risk Factors for Poor Adherence to Betaferon® Treatment in Patients with Relapsing-Remitting Multiple Sclerosis or Clinically Isolated Syndrome.
BACKGROUND
Adherence to treatment, including early treatment discontinuation, in patients with multiple sclerosis or clinically isolated syndrome can be affected by: treatment tolerability, route of drug administration, patient age, disease duration, comorbidities, medical care, and support from their caregivers.


OBJECTIVE
This study aimed to identify the risk factors for poor adherence to Betaferon® treatment, including early discontinuation and omitting doses.


METHODS
852 adult patients treated with Betaferon participated in this 24-month study. All patients were interviewed using the Risk of Drop-out Questionnaire, the Center for Epidemiologic Studies Depression Scale and the Kurtzke Expanded Disability Status Scale.


RESULTS
Patients who stopped therapy were younger (p = 0.003) had a higher mean EDSS score (p = 0.022), higher mean number of relapses (p = 0.017), and reported more often fear of injection (p = 0.027) and adverse events (p = 0.007) than those who did not stop treatment. Comparing patients who stopped therapy in the first and the second year, patients who stopped therapy in the first year of treatment more frequently reported flu-like symptoms and fever, and those who stopped therapy in the second year reported-ineffectiveness of treatment and disease progression. Multivariable logistic regression models confirmed that young age, short disease duration, advanced and progressing disease, and poor Betaferon tolerability were related to premature treatment discontinuation. The risk of omitting a dose during therapy was increased in patients who were working or studying, who had more advanced disease or more adverse events, and in patients who received less support from their caregivers.


CONCLUSIONS
Several reasons may lead to problems with adherence to Betaferon treatment. Patients at higher risk of discontinuing treatment need to be identified early to make caregivers' support available to them.
Department of Neurology, Poznań University of Medical Sciences, Poznań, Poland.
Łukasz
Ł
Jernas
Department of Neurolofy, "L. Bierkowski" Ministry of Internal Affairs and Administration Health Care Centre in Poznan, Poznań, Poland.
Jacek
J
Wencel
Department of Neurology, 4th Military Clinical Hospital in Wrocław, Wrocław, Poland.
Andrzej
A
Wiak
Bayer Sp. z o.o, Pharmaceuticals, Medical Department, Warsaw, Poland.
Marek
M
Bieniek
Faculty of Medicine. University of Rzeszow, Rzeszów, Poland.
Halina
H
Bartosik-Psujek
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D003863:Depression / Q000523:psychology; D018450:Disease Progression; D006801:Humans; D000068576:Interferon beta-1b / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016903:Drug Monitoring
D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b
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