Trent Doctorate in Clinical Psychology, University of Nottingham, Nottingham, United Kingdom.
College of Social Science, University of Lincoln, Lincoln, United Kingdom.
Mult Scler Relat Disord. 2024 Aug;88:105727. doi: 10.1016/j.msard.2024.105727. Epub 2024 Jun 12.
Adherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence.
To investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies.
Recruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed.
Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders.
Interventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence.
多发性硬化症（MS）患者对疾病修正治疗（DMT）的依从性差异很大。尽管研究经常将“遗忘”作为依从性差的原因之一，但很少有研究考虑认知问题如何影响依从性。
调查依从性的流行率和障碍，包括与 MS 相关认知问题的患者，以及确定与依从性相关的策略。
通过英国多发性硬化症登记处和多发性硬化症协会团体招募参与者，他们完成了药物依从性问卷和感知缺陷问卷。一部分参与者接受了采访。
在 257 名参与者中，94%的人报告依从性良好，尽管有 59%的人漏服≥1 剂，25%的人报告存在认知问题。有认知问题的患者依从性较低，他们遇到更多的障碍：记忆力问题；对服药的负面感受；不想让药物干扰活动。这些障碍以及情绪、认知和 DMT 给药方式，解释了依从性变化的 17%，静脉治疗是一个显著的预测因素。认知问题解释了差异的独特部分；然而，当考虑到焦虑时，这并不显著。访谈强调了对副作用和注射的焦虑以及对诊断的难以接受如何阻碍了提醒的使用。
针对认知和情绪问题的干预措施，减轻治疗负担和支持对诊断的调整，可能会提高依从性。
