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Published on: September 12, 2016
[Therapy adherence to immunomodulator treatment in patients with multiple sclerosis]
Pino López-Méndez1, Jordi Río, Ariadna Pérez-Ricart
1Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Espana.
Introduction:
Immunomodulator treatment modifies the course of the disease in patients with multiple sclerosis. The patient's adequate adherence with the treatment regimen is absolutely essential.
Aims:
To determine the real adherence with first-line immunomodulator treatment and to try to find out what factors may influence adequate adherence with the treatment.
Patients And Methods:
We conducted an observation-based, retrospective, longitudinal study of the patients being followed up by the Centre d'Esclerosi Multiple de Catalunya at the Hospital Universitari Vall d'Hebron that were given first-line immunomodulator treatment (interferons or glatiramer acetate) between 1st January 2010 and 30th September 2011. Adherence was measured using the medication possession ratio (MPR): patients with an MPR above or equal to 80% were considered to be compliers.
Results:
We studied 975 patients. The mean time of exposure to immunomodulators over the collected period was 13.4 ± 7.1 years. Altogether 85.2% of patients complied with the immunomodulator treatment adequately. Of a total of 975 patients treated, 134 needed to change to a second drug and 12 patients had to go on to a third. Changing the medication improved adherence (p = 0.001). The annual rate of attacks was 0.23. Only the presence of attacks (p = 0.029) and the drug used (p = 0.044) had any influence on treatment adherence, on an individual basis.
Conclusions:
The percentage of patients with adequate treatment adherence in our centre is high. The rate of attacks and the drug used play a decisive role. Close monitoring and personalised counselling are required to maintain good therapeutic adherence.
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