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Determinants of non-adherence to disease-modifying therapies in multiple sclerosis: A cross-Canada prospective study

Kyla A McKay1, Helen Tremlett1, Scott B Patten2

  • 1Division of Neurology, Faculty of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 1, 2016
PubMed
Abstract

Insights

Nearly a quarter of multiple sclerosis patients struggle with adherence to injectable therapies. Alcohol dependence, cognitive issues, and longer disease duration are linked to missing doses, aiding in identifying at-risk individuals.

Area of Science:

  • Neurology
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Adherence to disease-modifying therapies (DMTs) is crucial for managing multiple sclerosis (MS).
  • Non-adherence to injectable DMTs can significantly reduce treatment efficacy.
  • Understanding factors influencing adherence is key to improving patient outcomes in MS.

Purpose of the Study:

  • To identify and evaluate characteristics associated with non-adherence to injectable DMTs in MS patients.
  • To provide insights for healthcare professionals to better support patient adherence.

Main Methods:

  • A longitudinal study involving 485 MS patients from four Canadian clinics over two years.
  • Data collected included self-reported DMT use, missed doses, health behaviors, and comorbidities.
  • Generalized estimating equations were used to analyze factors associated with non-adherence (defined as <80% of doses taken).

Main Results:

  • Over 22% of participants exhibited non-adherence to injectable DMTs.
  • Non-adherence was significantly associated with alcohol dependence (OR: 2.14), self-reported cognitive difficulties (OR: 1.55), longer disease duration (OR: 2.23), and milder disability (EDSS 0-2.5, OR: 1.80).

Conclusions:

  • A substantial proportion of MS patients are non-adherent to injectable DMTs.
  • Key predictors of non-adherence include alcohol dependence, cognitive difficulties, disease duration, and disability level.
  • Identifying these characteristics can help clinicians proactively support patients at risk of poor adherence.
Keywords:
Multiple sclerosisadherencebeta-interferonglatiramer acetatehealth behaviorimmunomodulatory therapy

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