Determinants of non-adherence to disease-modifying therapies in multiple sclerosis: A cross-Canada prospective study

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dc.contributor.authorMcKay, Kyla A.
dc.contributor.authorTremlett, Helen
dc.contributor.authorPatten, Scott B.
dc.contributor.authorFisk, John D.
dc.contributor.authorEvans, Charity
dc.contributor.authorFiest, Kirsten
dc.contributor.authorCampbell, Trudy
dc.contributor.authorMarrie, Ruth Ann
dc.date.accessioned2019-01-24T21:11:54Z
dc.date.available2019-01-24T21:11:54Z
dc.date.issued2017
dc.descriptionThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by the Canadian Institutes of Health Research (CIHR CBG 101829), the Rx&D Health Research Foundation and by a Don Paty Career Development Award from the MS Society of Canada (to RAM).
dc.description.abstractBackground: Poor adherence to the disease-modifying therapies (DMTs) for multiple sclerosis (MS) may attenuate clinical benefit. A better understanding of characteristics associated with non-adherence could improve outcomes. Objective: To evaluate characteristics associated with non-adherence to injectable DMTs. Methods: Consecutive patients from four Canadian MS Clinics were assessed at three time points over two years. Clinical and demographic information included self-reported DMT use, missed doses in the previous 30 days, health behaviors, and comorbidities. Non-adherence was defined as <80% of expected doses taken. We employed generalized estimating equations to examine characteristics associated with non-adherence at all time points with findings reported as adjusted odds ratios (OR). Results: In all, 485 participants reported use of an injectable DMT, of whom 107 (22.1%) were non-adherent over the study period. Non-adherence was associated with a lower Expanded Disability Status Scale score (0-2.5 vs 3.0-5.5, OR: 1.80; 95% confidence interval (CI): 1.06-3.04), disease duration (>= 5 vs < 5 years, OR: 2.23; 95% CI: 1.10-4.52), alcohol dependence (OR: 2.14; 95% CI: 1.23-3.75), and self-reported cognitive difficulties, measured by the Health Utilities Index-3 (OR: 1.55; 95% CI: 1.08-2.22). Conclusions: Nearly one-quarter of participants were non-adherent during the study. Alcohol dependence, perceived cognitive difficulties, longer disease duration, and mild disability status were associated with non-adherence. These characteristics may help healthcare professionals identify patients at greatest risk of poor adherence.
dc.description.grantingagencyCanadian Institutes of Health Research
dc.identifier.citationMcKay, K. A., Tremlett, H., Patten, S. B., Fisk, J. D., Evans, C., … Fiest, K. (2016). Determinants of non-adherence to disease-modifying therapies in multiple sclerosis: A cross-Canada prospective study. Multiple Sclerosis Journal, 23(4), 588–596. https://doi.org/10.1177/1352458516657440
dc.identifier.doi10.1177/1352458516657440
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/35780
dc.identifier.grantnumberCBG 101829
dc.identifier.issn1352-4585
dc.identifier.urihttp://hdl.handle.net/1880/109521
dc.publisherSAGE PUBLICATIONS LTD
dc.publisher.departmentCritical Care Medicine
dc.publisher.facultyCumming School of Medicine
dc.publisher.hasversionPublished version
dc.publisher.policyhttps://us.sagepub.com/en-us/nam/faqs
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/
dc.subjectMultiple sclerosis
dc.subjectadherence
dc.subjectimmunomodulatory therapy
dc.subjectglatiramer acetate
dc.subjectbeta-interferon
dc.subjecthealth behavior
dc.titleDeterminants of non-adherence to disease-modifying therapies in multiple sclerosis: A cross-Canada prospective study
dc.typeArticle
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