Exploring medication adherence and illness perception in patients with neuroimmune diseases: a cross-sectional study

Neuroimmune diseases (NIDs) including myasthenia gravis (MG), multiple sclerosis (MS), and neuromyelitis optica spectrum disorder (NMOSD) require long-term medication adherence to optimize prognosis. This study aimed to investigate factors influencing medication adherence and its association with illness perception among NIDs patients.

A cross-sectional survey was conducted at the Outpatient Department of Neurology, West China Hospital, Sichuan University, from March to August 2025. Patients with clinically diagnosed MG, MS, or NMOSD and ≥ 6 months of treatment were enrolled. The questionnaire on basic information, the Eight-Item Morisky Medication Adherence Scale (MMAS-8), and the Brief Illness Perception Questionnaire (BIPQ) were used for data collection. SPSS 27.0, Prism and hiplot.cn were used for statistical analysis and illustration.

A total of 137 valid questionnaires were collected via face-to-face interviews. Univariate analyses showed significant differences in illness perception (F = 43.969, P < 0.001), disease duration (F = 4.182, P = 0.017), and average income (χ² = 16.590, P < 0.001) across adherence subgroups. Multiple linear regression identified illness perception (P < 0.001) and average income (P = 0.003) as independent predictors, with cognitive (P < 0.001) and emotional representations (P = 0.008) exerting negative effects. Subgroup analyses revealed illness perception as the primary predictor in MG/MS patients, while income additionally affected NMOSD patients (P = 0.014). Low and moderate income patients were respectively influenced by emotional and cognitive representations.

Illness perception and average income are key factors affecting medication adherence in NIDs patients, with diseases and income disparities. Individualized education targeting cognitive and emotional perceptions, along with economic considerations in treatment, may improve long-term outcomes.