Universidad Católica San Antonio, Guadalupe, Murcia, Spain.
CSUR Multiple Sclerosis Reference Center, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Clin Ther. 2020 May;42(5):e87-e99. doi: 10.1016/j.clinthera.2020.03.005. Epub 2020 Apr 30.
Multiple sclerosis is a chronic, demyelinating, and degenerative disease of the central nervous system with an immune-based pathologic origin. The present pilot study aimed to assess whether the change in the route of treatment administration is associated with a variation in adherence and whether there is a change in quality of life, treatment satisfaction, and fatigue.
Patients with relapsing-remitting multiple sclerosis who were >18 years of age and who used to receive immunomodulatory parenteral treatment and were ready to change administration route were eligible for the study. Data were collected at baseline and 3 months later. Adherence, quality of life, treatment satisfaction, and fatigue were measured via the following questionnaires: Morisky-Green questionnaire on patient-reported medication adherence, Multiple Sclerosis Quality of Life Instrument, Treatment Satisfaction Questionnaire for Medication, and Modified Fatigue Impact Scale.
The study sample included 30 patients (mean age, 43.2 years; age range, 24-71 years; 60% female and 40% male). There was a significant improvement in adherence (p = 0.048). Mean (SD) physical and mental health quality-of-life summary scores varied from 52.50 (24.15) and 54.13 (21.24) to 67.55 (20.92) and 62.30 (21.75) (p < 0.001 and p = 0.001, d = -0.426 and d = -0.643, respectively). In the Treatment Satisfaction Questionnaire for Medication, an improvement of the score was observed in effectiveness of the medication (p = 0.0041, d = -0.563), adverse effects of the medication (p < 0.001, d = -0.976), convenience of the medication (p < 0.001, d = -1.235), and global satisfaction (p = 0.006, d = -0.725). Patients had a higher mean (SD) score (45.13 [26.7]) on the Modified Fatigue Impact Scale while receiving injectable treatment compared with that obtained with oral treatment (34.86 [23.16]; p = 0.009, d = 0.41).
When the route of administration changed from injectable to oral, there was an increase in adherence, quality of life, and degree of patient satisfaction with their treatment and a decrease in the degree of fatigue.
多发性硬化症是一种中枢神经系统的慢性脱髓鞘和退行性疾病，具有免疫基础的病理起源。本初步研究旨在评估治疗途径的改变是否与依从性的变化相关，以及生活质量、治疗满意度和疲劳感是否发生变化。
本研究纳入年龄＞18 岁、曾接受免疫调节性的肠外治疗且准备改变给药途径的复发缓解型多发性硬化症患者。在基线和 3 个月后收集数据。通过以下问卷评估依从性、生活质量、治疗满意度和疲劳感：Morisky-Green 患者报告药物依从性问卷、多发性硬化症生活质量量表、治疗满意度问卷和改良疲劳影响量表。
研究样本包括 30 例患者（平均年龄 43.2 岁；年龄范围 24-71 岁；60%为女性，40%为男性）。依从性显著改善（p=0.048）。躯体健康和心理健康质量总评分从 52.50（24.15）和 54.13（21.24）分别变化至 67.55（20.92）和 62.30（21.75）（p＜0.001 和 p=0.001，d 值分别为-0.426 和-0.643）。在治疗满意度问卷中，观察到药物有效性（p=0.0041，d=-0.563）、药物不良反应（p＜0.001，d=-0.976）、药物便利性（p＜0.001，d=-1.235）和总体满意度（p=0.006，d=-0.725）评分的改善。与口服治疗相比，接受注射治疗的患者在改良疲劳影响量表上的平均（SD）评分（45.13[26.7]）更高（p=0.009，d=0.41）。
当给药途径从注射改为口服时，依从性、生活质量和患者对治疗的满意度增加，疲劳感降低。
