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Updated: Jan 2, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Risk Factors for Suboptimal Medication Adherence in Persons With Multiple Sclerosis: Development of an Electronic
Elizabeth S Gromisch1, Aaron P Turner2, Steven L Leipertz3
1Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, Connecticut; Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Neurology, University of Connecticut School of Medicine, Farmington, Connecticut; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, Connecticut.
Objective:
To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions.
Design:
Cross-sectional cohort study using electronic health records.
Setting:
Veterans Health Administration (VA).
Participants:
Veterans with multiple sclerosis (MS) (N=2939; 79.69% men) who received care through the VA and were included in the VA MS Center of Excellence Data Repository.
Interventions:
Not applicable.
Main Outcome Measures:
Suboptimal DMT adherence (<80%), demographics, co-occurring conditions, and health care use.
Results:
Nearly 31% of participants had suboptimal adherence. Flags for suboptimal adherence included >20% missed appointments (odds ratio [OR], 3.78; 95% CI, 2.45-2.82), traumatic brain injuries (OR, 1.55; 95% CI, 1.12-2.14), age younger than 59 years (OR, 1.47; 95% CI, 1.23-1.74), ≥1 emergency department visits (OR, 1.40; 95% CI, 1.18-1.67), mood disorders (ie, depressive and bipolar disorders) (OR, 1.40; 95% CI, 1.18-1.66), and service connection (OR, 1.22; 95% CI, 1.01-1.47). Hyperlipidemia (OR, 0.77; 95% CI, 0.65-0.92) and being issued a wheelchair (OR, 0.83; 95% CI, 0.70-1.00) were associated with lower risk.
Conclusions:
Suboptimal adherence to DMTs continues to be an issue. Interventions that focus on person-level barriers should be urgently explored to increase adherence and improve self-management abilities.
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