Adherence to Disease-Modifying Therapies for Multiple Sclerosis

Higuera, Lucas; Carlin, Caroline; Anderson, Sara E.

doi:10.18553/jmcp.2016.22.12.1394

Cited by 63 publications

(95 citation statements)

References 34 publications

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“…Compared to men, women in this study were 24% less likely to be adherent, a trend also observed recently by Higuera et al, who found that women with MS had a 5.5 percentage-point lower probability of being adherent (as measured by the MPR) than men 35. Although the reasons for poorer adherence among women remain speculative, one explanation is that more intense medication use may compromise adherence 36.…”

Section: Discussionsupporting

confidence: 79%

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis

Burks¹,

Marshall²,

Ye³

2017

CEOR

109

123

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Purpose To evaluate adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) initiating oral and injectable DMTs, and to estimate the impact of adherence on relapse, health resource utilization, and medical costs. Patients and methods Commercially insured MS patients (aged 18–65 years, two or more MS diagnoses, one or more DMT claims) with continuous eligibility 12 months before and after the first DMT claim date (index date) and no DMT claim during the pre-index period were identified from a large commerical claims database for the period from January 1, 2008, to September 30, 2015. Adherence to the index DMT was measured by the 12-month post-index proportion of days covered (PDC) and compared between oral and injectable DMT initiators. After adjustment for sex, age at index DMT, and comorbidities, regression models examined the relationship between adherence and relapse risk, MS-related health resource utilization, and non-drug medical costs (2015 US$). Results The study covered 12,431 patients and nine DMTs. Adherence to the index DMT did not differ significantly between oral (n=1,018) and injectable (n=11,413) DMTs when assessed by mean PDC (0.7257±0.2934 vs 0.7259±0.2869, respectively; P =0.0787), or percentages achieving PDC ≥0.8 (61.4% vs 58.6%, respectively; P =0.0806). Compared to non-adherence, adherence to DMT significantly reduced the likelihood of relapse in the post-index 12 months by 42%, hospitalization by 52%, and emergency visits by 38% (all, P <0.0001). Adherent patients would be expected to have on average 0.7 fewer outpatient visits annually versus non-adherent patients ( P <0.0001). Based on the differences in predicted mean costs, adherence (vs non-adherence) would decrease the total annual medical care costs by $5,816 per patient, including hospitalization costs by $1,953, emergency visits by $171, and outpatient visits by $2,802. Conclusion Adherence remains suboptimal but comparable between oral and injectable DMTs. Potential health and economic benefits underscore the importance of improving adherence in MS.

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Section: Discussionsupporting

confidence: 79%

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis

Burks¹,

Marshall²,

Ye³

2017

CEOR

109

123

View full text Add to dashboard Cite

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“…We found significant differences in TB in patients receiving oral versus injectable therapies. This has been previously described [30,31] and is an additional factor that must be taken into account when choosing specific disease-modifying treatments for the individual patient. We also detected significant correlation between TBQ scores and medication adherence.…”

Section: Discussionmentioning

confidence: 99%

Adaptation and validation of a Spanish version of the treatment burden questionnaire in patients with multiple sclerosis

et al. 2019

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Background: The Treatment Burden Questionnaire (TBQ) is a self-reported measure of the effect of treatment workload on patient wellbeing. We sought to validate the TBQ in Spanish and use it to estimate the burden of treatment in Argentinian patients with multiple sclerosis (MS). Methods: The TBQ was forward-backward translated into Spanish. Two focus groups and 25 semi-structured interviews focused on wording and possible item exclusion. Validation was performed in 2 steps. First, 162 patients across a range of MS severity completed the questionnaire. Confirmatory factor analysis assessed the dimensional structure of the TBQ. Construct validity was assessed by studying correlations with fatigue and quality of life (QoL). Then, in a second cohort of 171 patients, we evaluated the association between TBQ scores and patients' sex, age, education level, employment status, type of MS, disease duration, comorbidities, EDSS, pharmacological treatment and medication adherence. Results: The questionnaire presented a 3-factor structure in which burden was related to pharmacological treatment; comprehensive health assistance; and psycho-social-economic context. Composite reliability was > 0.8 for all factors. TBQ showed positive correlation with fatigue (r s = 0.467, p = 0.006), negative correlation with QoL (r s − 0.446, p = 0.009). For the second cohort, total TBQ score was 43 (SD 29). Lowest scores were observed on self-monitoring (0.53, SD 1.3) and highest for administrative load (4.2, SD 3.4). Inverse association was found between the TBQ score and medication adherence (r 0.243 p = 0.001). TBQ scores also correlated with daily patient pill/injection requirements (r 0.175 p = 0.020). Individuals receiving injectable treatment scored higher than patients on oral drugs (total TBQ 51 (SD 32) vs 39 (SD 27) p = 0.002). Conclusions: The TBQ in Spanish is a reliable instrument and showed adequate correlation with QoL and adherence scales in MS patients. TBQ may benefit health resources allocation and provide tailor therapeutic interventions to construct a minimally disruptive care.

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“…As a consequence, no adherence is defined as the "failing to fill prescriptions, delaying prescription fills, reducing the strength of the dose taken, and or reducing the frequency of administration. It can also include the failure to keep appointments or to follow the recommended lifestyle or dietary changes [5,6]." The availability of DMTs in low-to middle-income countries and adherence of MS patients to a medication that is not curing their disease are two critical challenges nowadays.…”

Section: Introductionmentioning

confidence: 99%

Adherence to self-administering interferon-β1a using RebiSmart® device in Mexican patients with relapsing multiple sclerosis

et al. 2020

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Background Adherence to disease-modifying therapies is determinant to attain maximal clinical benefit in multiple sclerosis (MS). RebiSmart® is an electronic auto-injector for subcutaneous delivery of interferon β-1a (INF-β1a) that monitors adherence by featuring a log of each drug administration for objective evaluation. The aim of this study was to assess long-term adherence to INF-β1a by using the RebiSmart® device in Mexican patients with relapsing MS. Methods This is an observational multicenter study on patients with relapsing MS treated with INF-β1a subcutaneously delivered by the RebiSmart® device. Adherence was computed as the number of injections received during the study period divided by the number of injections scheduled and expressed as percent. Results A total of 66 patients from 6 specialized MS centers were evaluated (45 females and 21 males, mean age 43.91±13.32 years). Mean adherence was 79.51±18% (median: 85.54%, range: 34.4-100%). During a median follow-up of 27.5 months (mean 33.36±29.39 months) the annualized relapse rate had a mean of 0.50±1.63. Mean initial EDSS was 1.90±1.52, and mean EDSS at the end of follow-up was 1.80±1.74. Compared with their counterparts, the mean number of relapses was significantly lower among patients with high (>80%) adherence (0.25±0.44 vs 0.67±92 relapses, respectively; P = 0.03). The proportion of relapse-free patients was 75.0% among patients with high adherence and 53.3% in low-PLOS ONE

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Adherence to Disease-Modifying Therapies for Multiple Sclerosis

Cited by 63 publications

References 34 publications

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis

Adaptation and validation of a Spanish version of the treatment burden questionnaire in patients with multiple sclerosis

Adherence to self-administering interferon-β1a using RebiSmart® device in Mexican patients with relapsing multiple sclerosis

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