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Published on: December 9, 2015
Treatment adherence in patients with multiple sclerosis: risk factors
L A Rodríguez de Antonio1, R Fernández de Córdoba-García2, N Herrero-Muñoz3
1Servicio de Neurología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain.
Introduction:
Adherence is a modifiable factor to disease-modifying treatments response in patients with multiple sclerosis (MS). Our objective is to assess the risk factors associated with inadequate adherence.
Method:
Retrospective study through review of medical records and review of the database of pharmaceutical dispensing of patients with MS of a tertiary hospital from 2004 to 2022. A multivariate logistic regression analysis of demographic, clinical, nosological, and therapeutic factors was performed between adherent and non-adherent patients and treatments.
Result:
546 treatments of 284 patients (67.3% women, age 38.4 ± 10.0) were analysed, observing 87.5% adherence. Non-adherent patients presented a higher EDSS at the end of treatment, were more frequently patients with secondary progressive multiple sclerosis, and had a higher proportion of cognitive impairment, psychiatric pathology, polypharmacy, and alcohol and drug use. After the multivariable analysis, risk factors were cognitive impairment (OR: 3.82 [1.51-9.70], P = .005), and alcohol and drug use (OR: 22.83 [7.32-71.20], P < .001). On the contrary, oral drugs favored better adherence (OR 0.29 [0.12-0.75], P = .01).
Conclusions:
Among many factors, alcohol or drug use and cognitive impairment are the major risk factors for low therapeutic adherence in patients with MS.
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