Therapeutic expectations of patients with multiple sclerosis upon initiating interferon beta-lb: Relationship to adherence to treatment

Abstract

This study, conducted in three separate outpatient health care delivery settings, examined the therapeutic expectations of patients with multiple sclerosis (MS) before they initiated interferon beta-1b therapy, the results of current educational procedures to correct unrealistic expectations, and the relationship between post-education expectations and discontinuing therapy. Ninety-nine consecutive patients were seen in a university based outpatient MS clinic, an academic group practice outpatient MS clinic, or a health maintenance organization outpatient neurology clinic. Before the educational sessions, 57% of the patients expressed unrealistically optimistic expectations regarding reduction in attack rate and 34% expressed unrealistically optimistic expectations regarding improvement in functional status. Educational procedures significantly altered unrealistic expectations but the results were sub-optimal since 33% of the patients maintained overly optimistic expectations regarding reduction in attack rate. Post-education unrealistic expectations of improvement in functional status were significantly related to discontinuing therapy within 6 months. Three adverse effects of therapy also were related independently to adherence to treatment: depression and flu-like symptoms were related to discontinuing therapy while soreness at injection site was related to continuing therapy.

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

“…8,30 Studies of adherence to MS therapy in clinical practice have shown that patients are more likely to discontinue DMTs within the first 6 months after initiation of treatment. 5,29 This was also observed in our cohort, indicating that regular patient support during this time may be particularly important. The high discontinuation rate in association with short disease duration and low EDSS score in our cohort is of concern and calls for action.…”

“…3,4 Discontinuation rates as high as 40% for first-line DMTs have been reported in the MS population. [5][6][7][8][9] Adverse effects,…”

Management Strategies for Flu-Like Symptoms and Injection-Site Reactions Associated with Peginterferon Beta-1a

“…3 Additionally, setting realistic expectations regarding MS treatment and adverse events was associated with improved adherence. [21][22][23] Because FLSs and ISRs are linked to treatment discontinuation and low adherence in patients with MS, setting realistic treatment expectations is critical and should be done tions (acetaminophen and/or an NSAID), dose titration, and administration at bedtime. 7,[18][19][20] Consequently, scheduled use of acetaminophen and/or an NSAID and changing the timing of injection were recommended as management strategies for FLSs in this study.…”

“…Questionnaire 1 responses were received between February 26 and May 4, 2014, and questionnaire 2 responses between September 15 and October 22,2014. From the 183 sites that participated in ADVANCE, 84 investigators met the inclusion criteria and were invited to participate.…”

A descriptive study of a pharmacist medication adherence program for patients with multiple sclerosis using interferon beta

“…However, the supply of INF-b to patients with RRMS in Malaysia is limited due to its high cost and limited public funds, 2 and studies estimate the rate of non-adherence to INF-b treatment to be 9-21% with the peak period of non-adherence being the first 6 months. [3][4][5] It is vital to ensure that patients adhere to the treatment regimen to obtain the best outcomes and minimise wastage. A pharmacist medication therapy adherence program was set up to improve patient adherence to INF-b treatment and to provide education on RRMS and INF-b.…”