Adherence to Disease-Modifying Therapy in Multiple Sclerosis: Part II

Abstract

Multiple sclerosis (MS) is a chronic, debilitating disease for which there is no cure; however, the recent introduction of injectable immunomodulating agents has reduced the rate of relapsing episodes and possibly slowed the progression of the disease. These disease-modifying agents are recommended by the National MS Society, but their true potential cannot be realized if patients do not accept them and healthcare professionals do not promote them. Since MS has an unpredictable course, and treatments can produce side effects, adherence to the recommended therapy is a complex and challenging issue. Improved understanding of the obstacles to adherence and the identification of possible solutions should be of value to nurses, who have numerous opportunities to encourage patients to initiate and continue therapy. Part I of this article, published in the September/October 2001 issue of Rehabilitation Nursing, described the particular problems of treatment adherence in MS. Part II proposes that the transtheoretical model of behavior change can be a useful tool in achieving both patient acceptance and treatment goals. This model is founded upon the concept that readiness for change is crucial, and that attempts at intervention should be sensitive to the patients' changing conditions and states of mind.

Supportive strategies to improve adherence to IFN beta-1b in Multiple Sclerosis — Results of the BetaPlus observational cohort study

“…However, these authors did not specifically address the influence of nurse support on treatment adherence, as it was the case in the present study. When this parameter was specifically addressed a positive effect of MS nurses on MS treatment adherence was documented [7,31].…”

A multicenter study of the predictors of adherence to self-injected glatiramer acetate for treatment of relapsing-remitting multiple sclerosis

“…The TTM has been used to develop a variety of instruments that measure readiness stage and evaluate the effectiveness of interventions to accelerate healthy changes such as adherence to exercise programs, smoking cessation, weight reduction, and safer sex practices [20,21]. Although the TTM has also been previously adapted to facilitate readiness for treatment of MS with disease-modifying therapies [23], our intent was to focus on a single behavior within the realm of MS treatment, that being the readiness to administer daily self-injections. Table 1 summarizes the stages of readiness and processes of change for adopting self-injection that were developed for this study.…”

Adherence to Disease-Modifying Therapies in Spanish Patients with Relapsing Multiple Sclerosis: Two-Year Interim Results of the Global Adherence Project

“…It has been observed that DMT might not be effective in those patients with a poor level of adherence in the long term [2]. According to different authors, the main factors that contribute to whether the patient is adherent are related to perceived lack of efficacy, lack of information or too complex information, false hopes of improvement in the disease, problems administering treatment (such as fear of needles or self-injections) and sociocultural factors [8,9]. …”