Al-Keilani Maha S, Almomani Basima A
Department of Clinical Pharmacy, College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Int J Pharm Pract. 2023 Apr 10;31(2):198-205. doi: 10.1093/ijpp/riac081.
To evaluate medication adherence to oral and parenteral disease-modifying therapies (DMTs) and to explore factors associated with medication non-adherence in patients with multiple sclerosis (MS).
A cross-sectional multicentre study was conducted among patients with MS. Patients who attended outpatient clinics of neurology departments from three major referral centres were invited to participate in the study. Medication adherence was measured using the Multiple Sclerosis Treatment Adherence Questionnaire.
A total of 319 patients with MS on DMT were included in the final analyses, their average age was 35 years and more than two-thirds (72.1%) of them were women. The adherent group comprised 46.7% of patients. The results of association analyses showed that factors that were associated with adherence level were female gender (P = 0.034), non-smoking/x-smoking (P = 0.007), school education (P = 0.019), unemployment (P = 0.006), history of previous DMT (P = 0.020), longer previous treatment duration (P = 0.008), and type of current DMT (P = 0.020). Among the non-adherent patients, there were significant differences between oral and parenteral DMT users in the importance of barriers to adherence (P < 0.001). Additionally, the degree of treatment satisfaction was higher in oral users than in parenteral users (P < 0.001).
The adherence level was quite low. Gender, smoking status, education, employment status, history of previous DMT, previous treatment duration and type of current DMT were associated with medication non-adherence in our patients with MS. These factors should be considered when evaluating medication adherence, and the modifiable factors may represent potential targets for interventions to improve pharmaceutical care planning in patients with MS.
评估口服和肠外疾病修正治疗(DMTs)的药物依从性,并探讨多发性硬化症(MS)患者药物不依从的相关因素。
对MS患者进行了一项横断面多中心研究。邀请了来自三个主要转诊中心神经内科门诊的患者参与研究。使用多发性硬化症治疗依从性问卷来测量药物依从性。
最终分析纳入了319例接受DMT治疗的MS患者,他们的平均年龄为35岁,其中超过三分之二(72.1%)为女性。依从组占患者的46.7%。关联分析结果显示,与依从水平相关的因素有女性性别(P = 0.034)、不吸烟/曾吸烟(P = 0.007)、学校教育程度(P = 0.019)、失业(P = 0.006)、既往DMT治疗史(P = 0.020)、既往治疗持续时间较长(P = 0.008)以及当前DMT类型(P = 0.020)。在不依从患者中,口服和肠外DMT使用者在依从障碍的重要性方面存在显著差异(P < 0.001)。此外,口服使用者的治疗满意度高于肠外使用者(P < 0.001)。
依从水平相当低。性别、吸烟状况、教育程度、就业状况、既往DMT治疗史、既往治疗持续时间和当前DMT类型与我们的MS患者药物不依从有关。在评估药物依从性时应考虑这些因素,其中可改变的因素可能代表改善MS患者药学服务计划干预措施的潜在目标。