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Am J Manag Care. 2010 Feb;16(2):139-44.
To examine the effect of a multiple sclerosis (MS) disease therapy management (DTM) program that incorporates a disease self-management component and a medication therapy management component within a structured 7-month program.
Observational cohort study.
Pharmacy claims were evaluated over an 8-month follow-up period to calculate injectable MS medication adherence and persistence among 156 continuously eligible patients who completed the DTM program compared with 156 patients in each of 2 propensity score-matched control groups (retail pharmacy patients and specialty pharmacy patients). For 283 patients completing the DTM program, the Short Form 12, Work Productivity Activity Impairment questionnaire, and MS relapses were assessed at month 0 and at month 6.
Injectable MS medication adherence was significantly higher for DTM patients compared with retail pharmacy patients (0.92 vs 0.86, P <.001) and was similar for DTM patients and specialty pharmacy patients (0.92 vs 0.90, P = .23). The DTM patients demonstrated significantly greater persistence on therapy (220 days) compared with the specialty pharmacy patients (188 days) (P = .002) and the retail pharmacy patients (177 days) (P <.01). The Short Form 12 and Work Productivity Activity Impairment results did not significantly change from month 0 to month 6. Multiple sclerosis relapses were reported by 14.0% of patients at month 0 and by 9.3% of patients at month 6 (P = .03). Ninety-seven percent of patients at month 6 reported that the DTM program was very helpful or somewhat helpful in enabling them to better manage their health.
An MS DTM program incorporating medication management resulted in increased adherence and persistence to injectable MS medications and decreased MS relapses. Quality of life and work productivity were not significantly changed. Patients reported improved ability to manage their health.
研究一种多发性硬化症（MS）疾病治疗管理（DTM）方案的效果，该方案将疾病自我管理部分和药物治疗管理部分纳入一个为期 7 个月的结构化计划中。
观察性队列研究。
在 8 个月的随访期间，评估了药房的索赔记录，以计算在完成 DTM 计划的 156 名连续合格患者中，与每个 2 个倾向评分匹配的对照组（零售药房患者和专科药房患者）中的 156 名患者相比，注射用 MS 药物的依从性和持久性。对于完成 DTM 计划的 283 名患者，在第 0 个月和第 6 个月评估了 12 项简短形式、工作生产力活动障碍问卷和多发性硬化症复发情况。
与零售药房患者相比（0.86 比 0.92，P <.001），DTM 患者的注射用 MS 药物依从性明显更高，与专科药房患者相似（0.92 比 0.90，P =.23）。DTM 患者的治疗持续时间明显更长（220 天），与专科药房患者（188 天）（P =.002）和零售药房患者（177 天）（P <.01）相比。从第 0 个月到第 6 个月，12 项简短形式和工作生产力活动障碍的结果没有显著变化。在第 0 个月，有 14.0%的患者报告多发性硬化症复发，在第 6 个月，有 9.3%的患者报告多发性硬化症复发（P =.03）。在第 6 个月，97%的患者报告 DTM 计划在帮助他们更好地管理健康方面非常有帮助或有些帮助。
纳入药物管理的 MS DTM 计划可提高注射用 MS 药物的依从性和持久性，并减少多发性硬化症的复发。生活质量和工作生产力没有显著变化。患者报告说，他们的健康管理能力得到了提高。
