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Abstract
Disease-modifying therapies can positively influence the progression of multiple sclerosis, but how many patients continue to take their medications? A new study shows that the majority of patients with multiple sclerosis stop treatment. Research should focus on ways to improve adherence to disease-modifying therapies.
Introduction
Several disease-modifying therapies (DMTs) have been shown to reduce disease exacerbations, inhibit the formation of brain lesions, and/or slow disease progression in relapsing–remitting multiple sclerosis (MS).[1] Despite moderate success in the development of these efficacious drug therapies, a recent study by Wong et al.[2] highlights a major problem with maintaining long-term treatment in this condition—patient adherence is poor and many patients stop treatment altogether.
Using a Canadian public health database, Wong and colleagues[2] retrospectively identified 682 patients with MS who had initiated treatment with intramuscular interferon (IFN)-β1a, subcutaneous IFN-β1b, IFN-β1b, or glatiramer acetate. Generally consistent with other studies examining DMT persistence, approximately half of patients with MS discontinued their DMT within 2 years of drug initiation. Poor treatment persistence was independent of drug costs and rarely related to patients switching to another class of DMT (switching between DMT types occurred in only 3.4–6.5% of patients).
The above results are not specific to MS; poor treatment adherence is common among patients with many types of chronic disease.[3] Nonetheless, patients with MS may be at especially high risk of poor long-term adherence for several reasons. DMTs do not typically reduce chronic symptoms; thus, patients do not experience any improvement in their daily activities while on medication. In fact, in some cases, patients experience adverse symptoms from the medications themselves and may, therefore, endure a reduction in quality of life while on therapy. Additionally, during periods of remission, patients with MS might become complacent and not feel the need to take their medication; conversely, they might question efficacy and discontinue their medication when doing poorly. Cognitive and emotional difficulties, which are common in patients with MS, can also impede treatment adherence.[4] Despite high rates of treatment discontinuation, few large-scale studies have examined the myriad factors that may contribute to poor treatment adherence in MS.
Full article:
http://www.medscape.com/viewarticle/747756
My blog on the topic:
http://activemsers.blogspot.com/2011...arguments.html
Abstract
Disease-modifying therapies can positively influence the progression of multiple sclerosis, but how many patients continue to take their medications? A new study shows that the majority of patients with multiple sclerosis stop treatment. Research should focus on ways to improve adherence to disease-modifying therapies.
Introduction
Several disease-modifying therapies (DMTs) have been shown to reduce disease exacerbations, inhibit the formation of brain lesions, and/or slow disease progression in relapsing–remitting multiple sclerosis (MS).[1] Despite moderate success in the development of these efficacious drug therapies, a recent study by Wong et al.[2] highlights a major problem with maintaining long-term treatment in this condition—patient adherence is poor and many patients stop treatment altogether.
Using a Canadian public health database, Wong and colleagues[2] retrospectively identified 682 patients with MS who had initiated treatment with intramuscular interferon (IFN)-β1a, subcutaneous IFN-β1b, IFN-β1b, or glatiramer acetate. Generally consistent with other studies examining DMT persistence, approximately half of patients with MS discontinued their DMT within 2 years of drug initiation. Poor treatment persistence was independent of drug costs and rarely related to patients switching to another class of DMT (switching between DMT types occurred in only 3.4–6.5% of patients).
The above results are not specific to MS; poor treatment adherence is common among patients with many types of chronic disease.[3] Nonetheless, patients with MS may be at especially high risk of poor long-term adherence for several reasons. DMTs do not typically reduce chronic symptoms; thus, patients do not experience any improvement in their daily activities while on medication. In fact, in some cases, patients experience adverse symptoms from the medications themselves and may, therefore, endure a reduction in quality of life while on therapy. Additionally, during periods of remission, patients with MS might become complacent and not feel the need to take their medication; conversely, they might question efficacy and discontinue their medication when doing poorly. Cognitive and emotional difficulties, which are common in patients with MS, can also impede treatment adherence.[4] Despite high rates of treatment discontinuation, few large-scale studies have examined the myriad factors that may contribute to poor treatment adherence in MS.
Full article:
http://www.medscape.com/viewarticle/747756
My blog on the topic:
http://activemsers.blogspot.com/2011...arguments.html
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