University Rome, Department of Neurological Sciences, La Sapienza University, S. Andrea Hospital, Multiple Sclerosis Centre, Viale dell'Università 30, 00185 Rome, Italy.
J Neurol Sci. 2011 Aug 15;307(1-2):120-6. doi: 10.1016/j.jns.2011.04.026. Epub 2011 Jun 1.
Low adherence to treatment in Multiple Sclerosis (MS) has been shown to lead to poor health outcomes. Various strategies to improve adherence have been suggested including educative programs, injection devices and dedicated nurse assistance.
To assess the impact of elements of the patient support program on adherence; to explore disease factors affecting adherence; and to determine whether these factors influence the choices of supportive elements.
A prospective, observational cohort study was conducted. MS patients were eligible if they had switched to Interferon beta-1b (IFNB-1b) between 1 and 3 months prior to inclusion. Data were collected at months 6, 12, 18 and 24 after inclusion. Adherence was defined as completion of both study protocol and medication at 24 months. Patients underwent evaluations of disability, quality of life, depression, and coping styles.
A total of 1077 patients from 15 countries were included, of which 61.8% were adherent to IFNB-1b after 24-months. Depression, quality of life and autoinjector devices were baseline predictors of adherence at 24-months. Coping styles did not show to have substantial impact on adherence. Lower quality of life increased the probability of choosing supportive elements.
The study showed that the usage of autoinjector devices chosen during the study was the strongest predictor of drug adherence of all the supportive elements tested in this study.
多发性硬化症（MS）治疗依从性低已被证明会导致不良健康结局。已经提出了各种提高依从性的策略，包括教育计划、注射装置和专门的护士协助。
评估患者支持计划的各个要素对依从性的影响；探讨影响依从性的疾病因素；并确定这些因素是否影响支持要素的选择。
进行了一项前瞻性、观察性队列研究。符合条件的 MS 患者在纳入前 1 至 3 个月内已转换为干扰素 beta-1b（IFNB-1b）。数据在纳入后第 6、12、18 和 24 个月收集。依从性定义为在 24 个月时完成研究方案和药物治疗。患者接受残疾、生活质量、抑郁和应对方式的评估。
共纳入来自 15 个国家的 1077 名患者，其中 61.8%的患者在 24 个月时对 IFNB-1b 有依从性。抑郁、生活质量和自动注射器设备是 24 个月时依从性的基线预测因素。应对方式对依从性没有显著影响。生活质量较低会增加选择支持要素的概率。
该研究表明，在本研究测试的所有支持要素中，自动注射器设备的使用是药物依从性的最强预测因素。
