Ruppin Academic Center, 3 Bait, Ruppin Academic Center, 4025000, Emeq Hefer, Israel.
Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
BMC Neurol. 2021 Mar 25;21(1):136. doi: 10.1186/s12883-021-02149-0.
Though adherence to disease-modifying therapies (DMTs) among persons with multiple sclerosis (PwMS) varies and is often below 80%, only few prospective studies on adherence examined predictors beyond demographic and clinical characteristics.
Identify antecedents to adherence and persistence to DMT in a prospective design among PwMS.
PwMS (n = 186) were prospectively assessed at three time points: baseline, 6 (Time 1) and 12 months later (Time 2). Clinical, demographic information and patient-reported medication beliefs, illness perceptions, medication habits, perceived health and affect were surveyed in-person. Adherence and persistence were assessed by a combination of self-reports and retrospective review of medication claims.
PwMS were 69.9% (Time 1) and 71% (Time 2) adherent to their DMTs and 64.5.9% were persistent. Beliefs about Medications were consistently predictive at both time points (baseline to Time 1 and Time 1 to Time 2) of medication adherence and persistence whereas other perceptions were predictive in some analyses; clinical and demographic characteristics were mostly not predictive of adherence nor persistence. The prospective association of beliefs about medication with adherence held also in multivariate analyses (OR = 0.88, 95% CI 0.78-0.99, p = 0.029).
Adherence and persistence are predicted by medication beliefs of PwMS. As medication beliefs are modifiable, they should be assessed periodically and targeted as a focus of tailored interventions aimed to improve adherence and consequently health outcomes in PwMS.
Clinical trials registry # NCT02488343 , date: 06/08/2015.
尽管多发性硬化症（MS）患者对疾病修正治疗（DMT）的依从性存在差异，且通常低于 80%，但仅有少数前瞻性研究检查了除人口统计学和临床特征以外的预测因素。
在 MS 患者的前瞻性设计中确定依从性和持续治疗的预测因素。
前瞻性评估了 186 名 MS 患者，共三个时间点：基线、6 个月（时间 1）和 12 个月（时间 2）。通过面对面访谈评估了临床、人口统计学信息，以及患者报告的药物信念、疾病感知、用药习惯、感知健康和情绪。通过自我报告和回顾性药物使用记录评估了依从性和持续性。
在时间 1 和时间 2，MS 患者分别有 69.9%（时间 1）和 71%（时间 2）患者坚持 DMT 治疗，分别有 64.5%和 64.9%患者具有持续性。药物信念在两个时间点（从基线到时间 1 和从时间 1 到时间 2）都能预测药物的依从性和持续性，而其他感知因素则在某些分析中具有预测性；临床和人口统计学特征对依从性和持续性大多没有预测作用。在多变量分析中，药物信念与依从性的前瞻性关联仍然成立（OR=0.88，95%CI 0.78-0.99，p=0.029）。
MS 患者的药物信念可以预测其依从性和持续性。由于药物信念是可改变的，因此应定期评估，并作为目标，以针对提高 MS 患者的依从性，并最终改善其健康结果的个体化干预措施的重点。
临床试验注册 #NCT02488343，日期：2015 年 06 月 08 日。
