scholarly journals Factors affecting adherence to disease-modifying therapies in multiple sclerosis: systematic review

2021 ◽  
Author(s):  
Francesca Washington ◽  
Dawn Langdon
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Adherence ◽  
Treatment Compliance ◽  
Clinical Effectiveness ◽  
Factors Affecting ◽  
Factors Associated ◽  
Related Hospitalisation ◽  
Contradictory Evidence ◽  
Disease Modifying ◽  
Injection Anxiety

AbstractPeople with multiple sclerosis (MS) face challenges adhering to disease-modifying drug (DMD) treatment. Poor adherence to treatment reduces its clinical effectiveness which can adversely impact disease progression, MS-related hospitalisation, and mortality rates. Understanding the barriers to adherence is essential to addressing these issues in clinical practice and a consolidation of the literature had not yet been carried out. A systematic search was carried out using the electronic databases PsycINFO, and PubMed (Medline) using the search terms treatment compliance or treatment adherence and multiple sclerosis or MS. Studies included adults, with a diagnosis of relapsing–remitting MS (RRMS) (sample > 80% RRMS), taking a DMD. The studies used an adequate measurement of treatment adherence and analysed possible factors associated with adherence. A total of 349 studies were retrieved, of which 24 were considered eligible for inclusion. Overall adherence rates of the included studies ranged from 52 to 92.8%. Narrative synthesis revealed the most prevalent factors associated with adherence were age, gender, depression, cognition, treatment satisfaction, injection-site reactions, and injection anxiety. There was contradictory evidence for disability in association with treatment adherence. The findings should be used to inform the development of targeted patient support programs which improve treatment compliance. The review also highlights the opportunities for advancing research into treatment adherence in MS.

scholarly journals Factors associated with time from first-symptoms to diagnosis and treatment initiation of Multiple Sclerosis in Switzerland

2018 ◽  
Vol 4 (4) ◽  
pp. 205521731881456 ◽  
Author(s):  
Marco Kaufmann ◽  
Jens Kuhle ◽  
Milo A Puhan ◽  
Christian P Kamm ◽  
Andrew Chan ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Initiation ◽  
Age At Onset ◽  
Older Age ◽  
Primary Progressive Multiple Sclerosis ◽  
Extended Time ◽  
Factors Associated ◽  
Time To Diagnosis ◽  
Disease Modifying ◽  
Disease Modifying Treatment

Background Recent studies emphasise the importance of timely diagnosis and early initiation of disease-modifying treatment in the long-term prognosis of multiple sclerosis. Objectives The objective of this study was to investigate factors associated with extended time to diagnosis and time to disease-modifying treatment initiation in the Swiss Multiple Sclerosis Registry. Methods We used retrospective data (diagnoses 1996–2017) of the survey-based Swiss Multiple Sclerosis Registry and fitted logistic regression models (extended time to diagnosis ≥2 years from first symptoms, extended time to disease-modifying treatment initiation ≥1 year from diagnosis) with demographic and a priori defined variables. Results Our study, based on 996 persons with multiple sclerosis, suggests that 40% had an extended time to diagnosis, and extended time to disease-modifying treatment initiation was seen in 23%. Factors associated with extended time to diagnosis were primary progressive multiple sclerosis (odds ratio (OR) 5.09 (3.12–8.49)), diagnosis setting outside of hospital (neurologist (private practice) OR 1.54 (1.16–2.05)) and more uncommon first symptoms (per additional symptom OR 1.17 (1.06–1.30)). Older age at onset (per additional 5 years OR 0.84 (0.78–0.90)) and gait problems (OR 0.65 (0.47–0.89)) or paresthesia (OR 0.72 (0.54–0.95)) as first symptoms were associated with shorter time to diagnosis. Extended time to disease-modifying treatment initiation was associated with older age at diagnosis (per additional 5 years OR 1.18 (1.09–1.29)). In more recent years, time to diagnosis and time to disease-modifying treatment initiation tended to be shorter. Conclusions Even in recent periods, substantial and partially systematic variation regarding time to diagnosis and time to disease-modifying treatment initiation remains. With the emerging paradigm of early treatment, the residual variation should be monitored carefully.

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