[Proposals to improve adherence to immunomodulatory therapies in patients with multiple sclerosis]

The objective of this work was to assess the factors identified in the Global Adherence Project (GAP) in disease-modifying therapy (DMT) in patients with multiple sclerosis (MS) and to propose measures directed at improving adherence. It was proposed to prepare questionnaires to detect patients at risk of non-adherence before and during the follow-up.

Two meetings were held by Spanish researchers involved in the GAP project. Factors associated with non-adherence were grouped in therapy-, patient-, disease- and health care professional-related factors. Four working groups were created. Each group studied one individual,factor, taking into account the stages of diagnosis, management and administering treatment, follow-up and discontinuation or change of treatment. A draft of proposals and tools (questionnaires) was agreed.

Patients should be provided with summaries of treatments, in a positive and simple way, and have time to discuss any doubts. Questionnaires should be given to patients at the start of treatment and during follow-up, so that individual characteristics can be assessed in order to monitor their adherence and act accordingly. Patients should be instructed in the management of the most common adverse reactions.

Therapeutic education to improve adherence to treatments and identification of non-adherent patients is recommended. We propose 2 questionnaires, initial and follow up, to stratify patients depending on their adherence.