Relationship between cognition and treatment adherence to disease-modifying therapy in multiple sclerosis: a...

Area of Science:

• Neurology
• Neuroscience
• Clinical Pharmacy

Background:

• Medication nonadherence is a significant challenge in managing chronic diseases, affecting up to 50% of patients.
• Adherence to disease-modifying therapies (DMTs) is crucial for managing multiple sclerosis (MS) progression and outcomes.
• Treatment selection plays a vital role in influencing patient adherence to long-term therapies.

Purpose of the Study:

• To investigate factors contributing to nonadherence to DMTs in patients with MS.
• To identify patient characteristics and treatment parameters associated with adherence or nonadherence to MS therapies.
• To provide insights for optimizing DMT selection and improving patient adherence in MS management.

Main Methods:

• Prospective, cross-sectional study conducted at a Multiple Sclerosis Center from 2018 to 2021.
• Analysis included 85 patients diagnosed with MS, assessing adherence to prescribed DMTs.
• Data collected included patient demographics, treatment type (oral vs. injection), treatment duration, Expanded Disability Status Scale (EDSS) scores, and Symbol Digit Modalities Test (SDMT) performance.

Main Results:

• 48.2% of MS patients were non-adherent to their DMTs.
• Nonadherence was associated with male sex, oral drug administration, and longer treatment duration.
• Higher SDMT scores, self-injection therapy, shorter treatment duration, and greater disability were linked to better adherence.

Conclusions:

• Patient information processing speed (cognitive function) and disability level are important considerations for DMT selection in MS.
• Discussing appropriate treatment options, considering individual patient factors, may help minimize nonadherence.
• Tailoring DMTs based on patient characteristics, including cognitive function and administration route preference, is essential for improving adherence in MS care.