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Factors that influence adherence with disease-modifying therapy in MS

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Abstract

Background

The complexity and cost of injection treatment can represent a formidable challenge for patients affected by a chronic illness, particularly those whose treatment is primarily preventative and only modestly effective on the more conspicuous symptomatic aspects of the disease process. The aim of this investigation was to identify which factors most influenced nonadherent behavior with the available diseasemodifying injection therapies for multiple sclerosis (MS).

Methods

A multicenter, observational (threewave) study using surveys was developed and administered to patients with MS through the World Wide Web. Healthcare providers at 17 neurology clinics recruited patients for the study.

Results

A total of 798 patients responded to the baseline wave of the study (708 responded to all three waves). The nonadherence rates for all patients (missing one or more injections) across these waves remained relatively stable at 39 %, 37 %, and 36 %, respectively. The most common reason participants listed for missing injections was that they simply forgot to administer the medication (58 %). Other factors including injection-site reactions, quality of life, patients’ perceptions on the injectable medications, hope, depression, and support were also assessed in relation to adherence.

Conclusions

This study characterizes factors that are associated with failure to fully adhere with disease modifying injection therapy for MS and underscores the principles associated with optimizing adherence and its implications for effective treatment of the disease process in MS.

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Authors and Affiliations

  1. Dept. of Neurology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX, 75235, USA

    Katherine Treadaway LCSW, Amber Salter MPH, Olaf Stüve MD, PhD & Elliot M. Frohman MD, PhD

  2. University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA

    Gary Cutter PhD

  3. University of Kansas Medical Center, Kansas City, KS, USA

    Sharon Lynch MD

  4. Neurology Associates of Fairfax, Fairfax, VA, USA

    James Simsarian MD

  5. University of Colorado Health Sciences Center, Denver, CO, USA

    John Corboy MD

  6. Wake Forest University Health Sciences Center, Winston-Salem, NC, USA

    Douglas Jeffery MD, PhD

  7. Northwestern University, Chicago, IL, USA

    Bruce Cohen MD

  8. Capital Neurology Services and MS Institute, Inc., Columbus, OH, USA

    Ken Mankowski DO

  9. Multiple Sclerosis Treatment Center at Griffin Hospital, Derby, CT, USA

    Joseph Guarnaccia MD

  10. Neurology Consultants of Amarillo, Amarillo, TX, USA

    Lawrence Schaeffer MD

  11. VIA Medical Center, Cheyenne, WA, USA

    Roy Kanter MD

  12. Hope Neurology, Knoxville, TN, USA

    David Brandes MD

  13. Louisiana Neurologic Consultants, Baton Rouge, LA, USA

    Charles Kaufman MD

  14. MKMG Neurology MS Center, Mount Kisco, NY, USA

    David Duncan MD

  15. Neurology Specialists of Dallas, Dallas, TX, USA

    Ellen Marder MD

  16. Neurology Consultants, Overland Park, KS, USA

    Arthur Allen MD

  17. Dallas Neurological Associates, Richardson, TX, USA

    John Harney MD

  18. East Bay Physicians Medical Group, Berkeley, CA, USA

    Joanna Cooper MD

  19. Medical College of Wisconsin, Milwaukee, WI, USA

    Douglas Woo MD

  20. Ohio State University Medical Center, Columbus, OH, USA

    Michael Racke MD

Authors
  1. Katherine Treadaway LCSW
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  2. Gary Cutter PhD
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  3. Amber Salter MPH
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  4. Sharon Lynch MD
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  5. James Simsarian MD
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  6. John Corboy MD
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  7. Douglas Jeffery MD, PhD
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  8. Bruce Cohen MD
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  9. Ken Mankowski DO
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  10. Joseph Guarnaccia MD
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  11. Lawrence Schaeffer MD
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  12. Roy Kanter MD
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  13. David Brandes MD
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  14. Charles Kaufman MD
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  15. David Duncan MD
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  16. Ellen Marder MD
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  17. Arthur Allen MD
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  18. John Harney MD
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  19. Joanna Cooper MD
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  20. Douglas Woo MD
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  21. Olaf Stüve MD, PhD
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  22. Michael Racke MD
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  23. Elliot M. Frohman MD, PhD
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Corresponding author

Correspondence to Elliot M. Frohman MD, PhD.

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Treadaway, K., Cutter, G., Salter, A. et al. Factors that influence adherence with disease-modifying therapy in MS. J Neurol 256, 568–576 (2009). https://doi.org/10.1007/s00415-009-0096-y

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  • DOI: https://doi.org/10.1007/s00415-009-0096-y

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