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Published on: December 9, 2015
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Medication adherence in multiple sclerosis as a potential model for other chronic diseases: a population-based cohort
Charity Evans1, Ruth Ann Marrie2, Shenzhen Yao3
1College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada charity.evans@usask.ca.
BMJ Open
|February 7, 2021
Summary
Medication adherence is higher in multiple sclerosis (MS) patients compared to other chronic diseases like epilepsy, Parkinson's, and rheumatoid arthritis. Specialized support programs for MS disease-modifying drugs (DMDs) likely contribute to this improved adherence.
Area of Science:
- Neurology
- Pharmacology
- Health Services Research
Background:
- Medication adherence is crucial for managing chronic conditions like multiple sclerosis (MS).
- Specialized support programs for disease-modifying drugs (DMDs) in MS may influence patient adherence.
- Comparative adherence rates across different chronic diseases are not well-established.
Purpose of the Study:
- To compare medication adherence in MS patients with those having epilepsy, Parkinson's disease (PD), and rheumatoid arthritis (RA).
- To investigate whether adherence in MS is linked to patient-specific or treatment-specific factors, particularly specialized DMD support programs.
Main Methods:
- Retrospective cohort study utilizing population-based health administrative data from three Canadian provinces (1996-2015).
- Inclusion criteria: patients with MS, epilepsy, PD, or RA receiving disease-related medication between 1997 and 2014.
- Optimal adherence (≥80%) was measured by medication possession ratio one year post-index date.
Main Results:
- A total of 126,478 subjects were analyzed (MS: 6,271).
- MS patients demonstrated significantly higher optimal 1-year adherence compared to epilepsy, PD, and RA patients (aORs ranging from 0.26 to 0.42 for non-MS conditions vs. MS).
- Within the MS cohort, adherence to DMDs was higher than non-MS chronic medications, with adherence linked to treatment factors rather than patient factors.
Conclusions:
- Multiple sclerosis patients exhibit superior medication adherence compared to those with epilepsy, PD, and RA.
- Treatment-specific factors, likely specialized support programs for MS disease-modifying drugs (DMDs), are associated with higher adherence.
- These specialized MS support programs may offer a transferable model for improving adherence in other chronic disease management settings.
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