Treadaway Katherine, Cutter Gary, Salter Amber, Lynch Sharon, Simsarian James, Corboy John, Jeffery Douglas, Cohen Bruce, Mankowski Ken, Guarnaccia Joseph, Schaeffer Lawrence, Kanter Roy, Brandes David, Kaufman Charles, Duncan David, Marder Ellen, Allen Arthur, Harney John, Cooper Joanna, Woo Douglas, Stüve Olaf, Racke Michael, Frohman Elliot M
Dept. of Neurology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235, USA.
J Neurol. 2009 Apr;256(4):568-76. doi: 10.1007/s00415-009-0096-y. Epub 2009 Apr 27.
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 disease-modifying injection therapies for multiple sclerosis (MS).
A multicenter, observational (three-wave) 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.
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.
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.
注射治疗的复杂性和成本对于慢性病患者而言可能是一项巨大挑战，尤其是那些治疗主要是预防性的且对疾病过程中较为明显的症状方面效果有限的患者。本研究的目的是确定哪些因素对多发性硬化症（MS）现有疾病改善型注射疗法的不依从行为影响最大。
开展了一项多中心、观察性（三阶段）调查研究，并通过万维网向MS患者进行了调查。17家神经科诊所的医疗服务提供者招募患者参与研究。
共有798名患者对研究的基线阶段做出了回应（708名患者对所有三个阶段都做出了回应）。在这些阶段中，所有患者（错过一次或多次注射）的不依从率分别保持在39%、37%和36%的相对稳定水平。参与者列出的错过注射的最常见原因是他们 simply forgot to administer the medication（58%）。还评估了其他因素，包括注射部位反应、生活质量、患者对注射药物的看法、希望、抑郁和支持与依从性的关系。
本研究描述了与未能完全坚持MS疾病改善型注射治疗相关的因素，并强调了与优化依从性相关的原则及其对MS疾病过程有效治疗的影响。
