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Risk factors for non-adherence to disease-modifying therapy in pediatric multiple sclerosis.
Carolyn E Schwartz1, Stephanie A Grover2, Victoria E Powell3
1DeltaQuest Foundation, Inc., Concord, MA, USA/Departments of Medicine and Orthopaedic Surgery, School of Medicine, Tufts University, Boston, MA, USA.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|March 10, 2017
Summary
Adherence to pediatric multiple sclerosis (MS) treatments varies by reporting method. Better physical functioning predicts better adherence, while parental involvement is linked to poorer school function and lower self-efficacy.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Adolescent Health
Background:
- Adherence to disease-modifying therapies (DMTs) is crucial for managing pediatric multiple sclerosis (MS).
- Understanding adherence patterns and risk factors in youth with MS is limited.
- This study investigates adherence to DMTs in a pediatric MS population.
Purpose of the Study:
- To determine the prevalence of poor adherence to DMTs in pediatric MS.
- To identify risk factors associated with non-adherence in this population.
- To explore the relationship between adherence, self-efficacy, and quality of life.
Main Methods:
- Cross-sectional study involving 66 youth with MS from 12 North American pediatric MS clinics.
- Data collection included pharmacy-refill data, patient/parent self-report adherence, quality of life, self-efficacy, and well-being measures.
- Factor analysis and linear regression were employed to analyze adherence predictors.
Main Results:
- Poor adherence estimates ranged from 7% (pharmacy) to 41% (patient self-report).
- Higher self-reported physical functioning was the strongest predictor of better adherence.
- Parental involvement in adherence correlated with poorer school functioning and lower MS self-efficacy.
Conclusions:
- Adherence rates in pediatric MS differ significantly based on the data source.
- Physical functioning is a key factor influencing treatment adherence in adolescents with MS.
- Parental involvement in adherence may indicate underlying challenges in the child's school functioning and self-management confidence.
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