The Impact of Patient Support Programs on Adherence to Disease-Modifying Therapies of Patients with Relapsing-Remitting Multiple Sclerosis in Germany: A Non-Interventional, Prospective Study

Abstract

Introduction: Disease-modifying therapies (DMTs) in multiple sclerosis (MS) are chronic therapies, and patients are likely to face challenges in adhering to DMT dosing regimens over time. DMT manufacturers offer patient support programs (PSPs) to increase adherence. PSPs are managed offerings typically encompassing nurse services, phone services, online resources, or mobile offerings. This study evaluated whether PSPs have a positive impact on adherence to DMTs among patients with mildto-moderate relapsing-remitting multiple sclerosis (RRMS) in Germany, independent of the treatment duration on DMT. Methods: This was a non-interventional, prospective, cross-sectional, multi-center study with patient-reported outcomes. Patients reported their DMT adherence using patient adherence questionnaires at four visits during an observation period of 24 weeks; PSP participation for this period was reported at the last visit. The primary objective was to evaluate the impact of PSPs on adherence across different DMTs by comparing patients with PSP participation versus no participation; adherence was defined as not missing a single dose of DMT. Results: One hundred eighty-four patients were analyzed (mean age: 44.6 years; 73.4% female; mean time on DMT: 7.2 years). Adherence across DMTs was significantly higher for PSP participants (92.9%) compared with nonparticipants (61.8%) (P = 0.0197). The observed rate of PSP participation (7.6%) was significantly lower than reported in earlier studies (P \ 0.0001); PSP awareness among patients analyzed was low (22.3%). Conclusion: We consider this study to have shown that PSPs have a positive impact on adherence to DMTs in MS, independent of the treatment duration on DMT. The majority of PSP participants also believe in this positive effect. PSP participation and patient awareness were low, and real-world adherence levels were found to be higher with self-injectable DMTs than with oral DMTs. In summary, physicians should actively advise patients with MS to participate in PSPs and, together with their patients, consider achievable real-world adherence under different DMTs when deciding MS treatment strategies.

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

“…Patient support programs designed to improve compliance have been found to have a positive impact on adherence rates of DMDs [ 44 ]. They have also been shown to reduce the number of relapses and healthcare costs due to improved treatment adherence [ 45 , 46 ].…”

Adherence to Therapy in Patients with Multiple Sclerosis—Review

“…Patient-support programmes that are offered by DMT manufacturers also have a positive impact on adherence to DMTs in patients with MS [62]. Jongen et al [63] also found associations between home care and adherence and between informal care and adherence.…”

“…The study conducted by Fensterheim et al [ 61 ] showed that patients who were new to DMT who had a one-to-one pharmacist video counselling conferencing session had significantly higher odds of being adherent. Patient-support programmes that are offered by DMT manufacturers also have a positive impact on adherence to DMTs in patients with MS [ 62 ]. Jongen et al [ 63 ] also found associations between home care and adherence and between informal care and adherence.…”

Patients’ knowledge and awareness about patient support programs: a cross-sectional study on Lebanese adults with chronic diseases

“…Our results showed that none of the 385 participants enrolled in the present study had been previously enrolled or was enrolled in a PSP during study time. Compared with other studies, the proportion of patient enrollment in PSPs was only 7.6 percent in a German study in 2020 (14), whereas it was higher in the Japan Fracture Observational Study (JFOS) (39.6%) (15) and a little bit higher in an U.S. study (56.7%) (16). PASSION study included participants from fourteen different countries such as Australia, Belgium, Czech Republic, France, Germany, Greece, Israel, Mexico, the Netherlands, Portugal, Puerto Rico, Slovakia, Switzerland, and the United Kingdom; it showed that 48.7 percent of patients were PSP users (17).…”