Purpose Adherence to disease-modifying treatments is essential in order to maximize the beneficial effects of treatment for multiple sclerosis (MS). There are numerous treatments that have been approved. Treatment selection is essential in patient adherence. In addition, patient preference plays an increasingly significant role in treatment decision-making. This study aims to evaluate the degree of adherence, along with other variables that may influence this adherence, in Spain. Methods A cross-sectional study was conducted with 157 MS patients with disease-modifying treatments. Adherence was assessed using the Morisky Green scale, and other related factors were measured using a questionnaire that addressed demographics, disease characteristics, global perception of pathology, impact of medication on patient’s life, and treatment decision-making. Results The adherence rate was 71% and was associated with the following variables: older age, more treatments received, time to diagnosis 5–10 years, absence of exacerbations, better cognitive status, being married/in a union, clear information about the disease, and higher treatment satisfaction. The main cause for non-compliance was forgetfulness (27%). Conclusion The adherence rate is acceptable. It is widely known that treatment satisfaction is related to adherence. In our study, patients’ level of satisfaction was higher with oral treatments. However, oral administration showed a greater lack of adherence. The main cause of lack of adherence was forgetfulness. In relation to other variables, cognitive status and family support showed a correlation with treatment adherence.

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BackgroundThe outpatient pharmacy unit (OPU), in consensus with the digestive service (DIG), held an intervention on selected chronic hepatitis B virus (HBV) infected outpatients. It consisted of decreasing the frequency of oral treatment from a monthly to a bimonthly basis. The aim was to reduce patient visits to the hospital and to diminish the healthcare burden in order to use human resources to improve pharmaceutical care.PurposeTo evaluate the impact on adherence and viral load (VL) after dispensing treatment on a bimonthly basis instead of a monthly basis to selected HBV outpatients.Material and methodsIn May 2014, patients were transversely selected by OPU following the criteria reached by consensus with DIG: age >18 years, receiving any oral drug (alone or combined) for HBV infection, HBV VL ≤100 copies/mL in their last analysis, on stable treatment for at least 6 months previous to the study and related adherence throughout that period >80%. All selected patients were informed about the importance of adherence, and bimonthly dispensation was offered to them. The next set of data was collected from the medical records: sex, age and VL. Adherence was measured by indirect methods from the dispensation programme registry (Farmatools). In May 2015, adherence since the intervention and VL values were revised for the selected patients to evaluate the effect of the intervention.Results94 patients met the criteria but only 73 wanted to change to bimonthly dispensation: 56.15% male, median (P50) age 52 (44–61). Results refer to 63 patients, as 8 patients had no analysis after the intervention and 2 were lost to follow-up. After the intervention, 6 patients still met the criteria. 35 patients maintained the same VL and 17 had decreased VL (13 to undetectable). 9 had increased VL but still met the criteria and 8 of them had adherence variation <10%. Causes of not meeting the criteria: 1 patient for changing treatment (simplification) and 1 patient for diminished adherence from 88.24% to 57.13%. This patient returned to monthly dispensation.ConclusionBimonthly dispensation is a safe tool for maintaining stable adherence and VL in selected patients and could be used to rationalise the use of the limited human resources of pharmacy services and reduce patient visits to hospital.References and/or AcknowledgementsIbarra O. Adherencia al tratamiento VHB. Grupo Hepatopatías Víricas. SEFH.2 junio 2010. BarcelonaNo conflict of interest.

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were previously established and taking RoB into account in the interpretation of results. The only high-quality study (5%) reported on the sources of funding for the studies included in the review and provided a list of excluded articles. Conclusion and Relevance Systematic reviews provide the best level of evidence, but their quality must be assured. The overall quality of the systematic reviews measuring the impact of PHARMACIST-LED AMS interventions is low. There is a need for high level literature covering the participation and implication of pharmacists in AMS. The real impact of AMS is unknown to support policy makers and efficient designs in both clinical practice and research.