[Adherence to long-term therapy with disease modifying drugs]

Area of Science:

• Neurology
• Clinical Pharmacology
• Patient Adherence Research

Background:

• Long-term adherence to disease-modifying drugs (DMDs) is essential for managing chronic conditions like multiple sclerosis (MS).
• Understanding factors influencing treatment rejection is critical for improving patient outcomes in MS.
• Patient choice plays a significant role in the acceptance or rejection of prescribed therapies.

Purpose of the Study:

• To investigate socio-demographic, neurological, and neuropsychological factors associated with the rejection of DMD treatment in multiple sclerosis patients.
• To identify specific DMDs and patient characteristics linked to higher rates of treatment withdrawal.
• To determine critical time periods and independent predictors of DMD rejection.

Main Methods:

• Comparative study of 153 multiple sclerosis patients at a Moscow center, divided into groups receiving or rejecting DMD treatment.
• Utilized the Expanded Disability Status Scale (EDSS), Hospital Anxiety and Depression Scale (HADS), and a custom socio-demographic questionnaire.
• Analyzed neurological, socio-demographic, and neuropsychological data to identify factors associated with treatment rejection.

Main Results:

• Glatiramer acetate was associated with lower rejection rates compared to other DMDs.
• Previous DMD withdrawal was a predictor of future rejection; the initial four months of treatment posed the highest risk.
• Independent factors for rejection included lack of family support, unemployment, and age; anxiety, lack of cooperation, and poor compliance were also significant.
• No correlation was found between treatment rejection and depression, MS duration, or MS course type.

Conclusions:

• Treatment adherence in multiple sclerosis is influenced by a complex interplay of patient-related factors, including social support, employment status, and psychological disposition.
• Early intervention and targeted support during the initial treatment phase may mitigate DMD rejection.
• Glatiramer acetate may offer a more favorable adherence profile in certain patient populations.