A preliminary analysis of predictors of disease-modifying therapy (DMT) adherence, presented at the American Academy of Neurology 2015 annual meeting, reinforces the notion that patient–provider communication is of primary importance.
Among patients with relapsing-remitting multiple sclerosis who were surveyed online between November and December 2012, those who had discussions with their neurologist about the details of medication safety or their satisfaction with their current therapy were more likely to have high adherence to their treatment. Those who did not discuss such parameters as the medication’s long-term safety or treatment costs were less likely to be very adherent to their treatment.
“The biggest takeaway is understanding what is important to patients,” lead investigator Julie C. Locklear, PharmD, MBA, Vice President of Health Economics and Outcomes Research, EMD Serono Inc, Rockland, MA, told Value-Based Care in Neurology.
“It is essential for providers to [give] patients...all the information they need regarding their treatment options and the importance of adherence to the medications for the treatment of multiple sclerosis,” Dr Locklear said.
The participants comprised a random sample of patients who completed the US National Health and Wellness Survey or participated in the Lightspeed Research panel. They were all at least 18 years old, had never participated in a clinical trial, and had been using their current DMT for at least 4 months. The survey included the 4-item Morisky Medication Adherence Scale.
A total of 579 patients met the criteria for the analysis. Of these, 40% of patients had forgotten at some time to take their medication; 20.4% admitted to being careless at times about taking their medicine; 7.3% said they sometimes stop taking their medicine if they feel worse; and 6.4% said they sometimes stop taking their medication if they feel better.
The researchers calculated that 52.3% (N = 303) of patients had high medication adherence, and the other 276 patients had intermediate or low medication adherence.
Patients using their current therapy for a longer time, those who had skipped a dose because of cost, and those who had not filled or refilled a prescription for their DMT because of cost were more likely to have low treatment adherence.
Basic calculations revealed variables that were associated with increased likelihood of adherence, including:
- Insurance coverage of the full cost of the DMT (odds ratio [OR], 1.712; P = .013)
- Talking about the safety of the patient’s DMT (OR, 1.535; P = .011)
- Discussing how long the treatment had been on the market (OR, 1.466; P = .023)
- Drug effective at preventing lesions (OR, 1.025; P = .01).
As has been shown in other studies, the factors associated with low adherence included various aspects of the medication cost, and not discussing cost. However, components of the information shared between patients and providers were also significant, such as not discussing the DMT’s long-term safety with the provider and not talking about how long the treatment had been available.