J Neurosci Nurs. 2010 Oct;42(5 Suppl):S10-8. doi: 10.1097/jnn.0b013e3181ee122b.
A key aspect of the management of care for patients with multiple sclerosis (MS) is identifying which patients are struggling with adherence. Disease-modifying therapies for the treatment of MS are primarily preventative, with modest efficacy, and they can possibly cause significant side effects. These factors can lead patients to stop taking their medication because they continue to experience symptoms or relapses of the disease, and/or they have painful injection-site reactions on most parts of their bodies. However, striving for 100% adherence to the prescribed treatment regimen remains the goal and is the surest way to reap all the benefits associated with immunomodulatory therapy. Building trust, promoting injection self-efficacy, and educating patients about proper injection techniques to prevent injection-site reactions have the greatest impact on patient adherence. Factors including family involvement, financial stability and support, hope, and faith can also have a positive impact on adherence. Identifying patients who may be struggling with depression, which is easily treatable but often not well addressed, and providing access to mental health services are important. Although many strides have been made with regard to MS patient care, outlining strategies that can maintain or encourage adherence can provide practitioners with tools to facilitate their patients' health and well-being.
管理多发性硬化症 (MS) 患者护理的一个关键方面是确定哪些患者在坚持治疗方面存在困难。用于治疗 MS 的疾病修正疗法主要是预防性的，疗效有限，并且可能会引起明显的副作用。这些因素可能导致患者停止服用药物，因为他们仍在经历疾病的症状或复发，和/或他们在身体的大部分部位出现疼痛的注射部位反应。然而，努力达到 100%的依从性仍是目标，也是获得与免疫调节治疗相关的所有益处的最可靠方法。建立信任、提高注射自我效能感、教育患者正确的注射技术以预防注射部位反应，对提高患者的依从性有最大的影响。包括家庭参与、财务稳定和支持、希望和信仰在内的因素也可能对坚持治疗产生积极影响。确定可能正在与抑郁作斗争的患者，抑郁很容易治疗，但往往没有得到很好的解决，并提供获得心理健康服务的机会，这一点很重要。尽管在 MS 患者护理方面已经取得了许多进展，但制定可以维持或鼓励坚持治疗的策略，可以为从业者提供工具，促进患者的健康和福祉。
