Department of Neuropsychiatry, Faculty of Medicine, Assiut University Hospital, Asyût, Egypt.
Neuropsychiatric Department, Faculty of Medicine, Aswan University Hospital, Aswân, Egypt.
Sci Rep. 2024 Mar 25;14(1):7027. doi: 10.1038/s41598-024-57116-9.
Despite the proven efficacy of the disease-modifying therapy (DMT) for multiple sclerosis (MS), the rates of non-adherence are frequently high. We aimed to evaluate the rate of non-adherence to the first DMT in Upper Egypt and identify different contributing factors. Out of 310 patients, ninety-seven adult patients with RRMS were recruited from three MS units located in Upper Egypt and were subjected to the following: complete clinical history, expanded disability status score (EDSS), Eight-item Morisky Medication Adherence Scale (MMAS-8), abbreviated Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), Hamilton depression scale, Fatigue Severity Scale (FSS) and the Pittsburgh Sleep Quality Index (PSQI). According to MMAS-8 scores, 63 (64.9%) of patients were non-adherent to their first DMT. Non-adherent patients are more likely to have longer disease duration (p = 0.002), longer duration on first DMT (p = 0.030), first DMT-start date before 2019 (p = 0.040), and lower treatment satisfaction scores (p = 0.016). However, there was no significant relation with physical disability, depression, fatigue, or sleep quality. On the regression analysis model, a lower treatment satisfaction score was the only predictor of DMT non-adherence (p = 0.012). Despite expanding DMT options, non-adherence among MS patients in Upper Egypt is high. Treatment satisfaction with DMT is the only predictor of adherence among MS patients of Upper Egypt. Adherence and satisfaction with the prescribed DMT should be assessed carefully to maximize DMT benefits.
尽管疾病修正治疗 (DMT) 对多发性硬化症 (MS) 已被证实具有疗效，但不遵医嘱的情况仍经常发生。我们旨在评估上埃及地区首次 DMT 治疗的不遵医嘱率，并确定不同的影响因素。在 310 名患者中，我们招募了来自上埃及三个 MS 中心的 97 名 RRMS 成年患者，并对他们进行了以下评估：完整的临床病史、扩展残疾状态评分 (EDSS)、八项 Morisky 药物依从性量表 (MMAS-8)、简短治疗满意度问卷-药物 9 项 (TSQM-9)、汉密尔顿抑郁量表、疲劳严重程度量表 (FSS) 和匹兹堡睡眠质量指数 (PSQI)。根据 MMAS-8 评分，63 名（64.9%）患者不遵医嘱使用他们的 DMT。不遵医嘱的患者更有可能具有更长的疾病病程（p=0.002）、首次 DMT 持续时间更长（p=0.030）、首次 DMT 开始日期早于 2019 年（p=0.040）和更低的治疗满意度评分（p=0.016）。然而，这与身体残疾、抑郁、疲劳或睡眠质量无关。在回归分析模型中，较低的治疗满意度评分是 DMT 不遵医嘱的唯一预测因素（p=0.012）。尽管扩大了 DMT 选择，但上埃及地区的 MS 患者不遵医嘱的情况仍然很高。DMT 治疗的满意度是上埃及 MS 患者遵医嘱的唯一预测因素。应仔细评估患者对 DMT 的依从性和满意度，以最大限度地发挥 DMT 的益处。
