Narrative Review of the Literature on Adherence to Disease-Modifying Therapies Among Patients with Multiple Sclerosis

Menzin, Joseph; Caon, Christina; Nichols, Christine; White, Leigh Ann; Friedman, Mark I.; Pill, Michael W.

doi:10.18553/jmcp.2013.19.s1.s24

Cited by 178 publications

(204 citation statements)

References 39 publications

(114 reference statements)

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“…Another 4-year study reported adherence rates of 52.2-62.3% for GA and IFNs 27 . Similar rates were also reported in a review that included 24 studies of adherence to DMTs, with weighted mean adherence rates for GA and IFNs ranging between 56.8% and 69.4% 43 . This review also noted that the highest rates of adherence were seen with the DMTs that required least frequent administration 43 , indicating that patients may be averse to frequent injections and that DMTs with a convenient mode of administration and dosing schedule may improve patient adherence.…”

Section: Discussionsupporting

confidence: 75%

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Bergvall

Petrilla

Karkare

et al. 2014

Journal of Medical Economics

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Objective: Achieving therapeutic goals in multiple sclerosis (MS) requires strict adherence to treatment schedules. This retrospective study analyzed persistence with, and adherence to, fingolimod compared with injectable/ infusible disease-modifying therapies (DMTs) in patients with MS. Methods:Patients in the PharMetrics Plus TM US administrative claims database with at least one prescription for, or administration of, fingolimod, glatiramer acetate (GA), interferon (IFN), or natalizumab (index DMT) between October 1, 2010 and September 30, 2011 were included. Patients were naïve to index DMT (no claim in the previous 360 days) and had an MS diagnosis code within 360 days of the first index DMT prescription. Outcomes were persistence, risk of discontinuing index DMT (evaluated by a Cox proportional hazards model), adherence (measured using the medication possession ratio [MPR] and proportion of days covered [PDC] in patients with at least two index DMT prescriptions), and the risk of being non-adherent (MPR580% and PDC 580%, assessed using a logistic regression model). Results:The study included 3750 patients (fingolimod, n ¼ 889; GA, n ¼ 1233; any IFN, n ¼ 1341; natalizumab, n ¼ 287). Discontinuation rates (fingolimod, 27.9%; GA, 39.5%; IFN, 43.7%; natalizumab, 39.5%; all p50.001) and risk of discontinuation were significantly higher (hazard ratios vs fingolimod [95% confidence interval]: GA, 1.75 [1.49-2.07]; IFN, 2.01 [1.71-2.37]; natalizumab, 1.53 [1.22-1.91]) for patients receiving other DMTs compared with fingolimod. The risk of being non-adherent was also lower for patients in the fingolimod cohort than the other treatment cohorts, irrespective of whether nonadherence was defined as MPR580% (p50.05 for all) or PDC580% (p50.05 for GA and IFN). Limitations:As with all studies assessing real-world treatment patterns it is unclear if medications were used as prescribed. Conclusions:In a real-world setting, persistence with, and adherence to, oral fingolimod was higher than for injectable and infusible DMTs.

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Section: Discussionsupporting

confidence: 75%

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Bergvall

Petrilla

Karkare

et al. 2014

Journal of Medical Economics

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“…Injection-related reasons for nonadherence include physical or cognitive difficulties, perceived lack of treatment efficacy, treatmentrelated AEs occurring with each injection, injection anxiety, needle phobia, and injection fatigue [Lugaresi, 2009;Patti, 2010;Menzin et al 2013]. New treatments with prolonged efficacy that allow for increased time between doses have now been developed; these require fewer overall injections when compared with older treatments, thereby reducing injection-related factors experienced by patients [Menzin et al 2013;Patti, 2010;Shingler et al 2013].…”

Section: Introductionmentioning

confidence: 99%

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Poulos

Kinter

Yang

et al. 2016

Ther Adv Neurol Disord

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Objectives: The aim of this study was to assess the relative importance of features of a hypothetical injectable disease-modifying treatment for patients with multiple sclerosis using a discrete-choice experiment. Methods: German residents at least 18 years of age with a self-reported physician diagnosis of multiple sclerosis completed a 25-30 minute online discrete-choice experiment. Patients were asked to choose one of two hypothetical injectable treatments for multiple sclerosis, defined by different levels of six attributes (disability progression, the number of relapses in the next 4 years, injection time, frequency of injections, presence of flu-like symptoms, and presence of injection-site reactions). The data were analyzed using a random-parameters logit model. Results: Of 202 adults who completed the survey, results from 189 were used in the analysis. Approximately 50% of all patients reported a diagnosis of relapsing-remitting multiple sclerosis, and 31% reported secondary progressive multiple sclerosis. Approximately 71% of patients had current or prior experience with injectable multiple sclerosis medication. Approximately 53% had experienced flu-like symptoms caused by their medication, and 47% had experienced mild injection-site reactions. At least one significant difference was seen between levels in all attributes, except injection time. The greatest change in relative importance between levels of an attribute was years until symptoms get worse from 1 to 4 years. The magnitude of this difference was about twice that of relapses in the next 4 years, frequency of injections, and flu-like symptoms. Conclusions: Most attributes examined in this experiment had an influence on patient preference. Patients placed a significant value on improvements in the frequency of dosing and disability progression. Results suggest that changes in injection frequency can be as important as changes in efficacy and safety attributes. Understanding which attributes of injectable therapies influence patient preference could potentially improve outcomes and adherence in patients with multiple sclerosis.

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“…Better, however, does not necessarily mean safer or more efficacious, or easier to administer or to follow up. Despite the clearly established benefits of DMDs, the rate of adherence remains moderate, at best, in the few studies assessing these parameters 2,3,4,5 . The present study assessed the degree of satisfaction of patients with MS regarding treatments with DMDs prescribed for them at five different Brazilian MS Units.…”

mentioning

confidence: 99%

Patients’ satisfaction with and views about treatment with disease-modifying drugs in multiple sclerosis

Spessotto

Cavalli

Eboni³

et al. 2016

Arq. Neuro-Psiquiatr.

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Objective The treatment of multiple sclerosis (MS) with disease-modifying-drugs (DMDs) is evolving and new drugs are reaching the market. Efficacy and safety aspects of the drugs are crucial, but the patients’ satisfaction with the treatment must be taken into consideration. Methods Individual interview with patients with MS regarding their satisfaction and points of view on the treatment with DMDs. Results One hundred and twenty eight patients attending specialized MS Units in five different cities were interviewed. Over 80% of patients were very satisfied with the drugs in use regarding convenience and perceived benefits. The only aspect scoring lesser values was tolerability. Conclusion Parameters for improving treatment in MS must include efficacy, safety, and patient satisfaction with the given DMD.

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Narrative Review of the Literature on Adherence to Disease-Modifying Therapies Among Patients with Multiple Sclerosis

Cited by 178 publications

References 39 publications

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Patients’ satisfaction with and views about treatment with disease-modifying drugs in multiple sclerosis

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