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

T V Sidorenko, A N Boĭko, M F Davydovskaia

    Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
    |November 7, 2009
    PubMed

    Insights

    Adherence to multiple sclerosis (MS) treatment is crucial. Factors like lack of family support, unemployment, and anxiety increase the risk of patients rejecting disease-modifying drugs (DMDs).

    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.

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