Disease Modifying Therapies – Risk Management Poster Presentation

P0372 - Predictors of  Therapeutic Adherence in Multiple Sclerosis  in Argentina   (ID 1425)

Speakers
  • E. Drzewiscki
Authors
  • G. Zanga
  • D. Caruso
  • P. Tagliani
  • M. Esnaola Y Rojas
Presentation Number
P0372
Presentation Topic
Disease Modifying Therapies – Risk Management

Abstract

Background

Adherence to prescribed treatment in chronic disease is a critical factor for a successful therapeutic response. However, in conditions like multiple sclerosis (MS), where the treatment is mainly preventive, it might be inadequate. The reasons for poor adherence may be related to multiple factors.

Objectives

The objective is to evaluate adherence to Multiple Sclerosis treatment and identify predictors that could affect it.

Methods

This is a cross-sectional study consisting of a cohort of MS patients conducted at a National Medical Care Program: PAMI (Programa Atención Médica Integral) in Argentina, during January 1st and October 1st 2017 available in the database of drug dispensing. Variables related to disease, patient, health system and treatment were evaluated from a brief telephone survey. The medication possession ratio (MPR) was used to estimate adherence, MPR<80% defined nonadherence. The association between predictor variables and adherence were assessed with a logistic regression model.

Results

Out of the 648 patients included in the database, a total of 360 (55.5%) surveys were conducted. 311/360 (86.4%) stated that they were receiving treatment for MS at the moment of the survey. Mean age was 55.3 (SD 12), 216 (60%) female. The optimal adherence to treatment was 45.3%.

Median disease duration was 14.5 years (IQR 13). During last year, 117 (32.5%) had relapses. Fatigue was moderate to severe in 297 (82.5%) of patients, 201 (56%) patients required assistance to walk. 107 (33.6%) of patients forgot to take the medication and 103 (29%) presented symptoms suggestive of depression.The mean of neurological controls were 3.8 (SD 2.6) per year. The median delay to authorization of medication was 2.3 (IQR 10) weeks.

198 (63.7%) received injectables therapies, most commonly used were interferons. In the multivariate model, we only found an association between adherence and the oral route of administration (OR 1.96 CI95% 1.20-3.20, p= 0.006). In a secondary post hoc analysis we found that the predictors of receiving oral drugs were higher educational level (OR 2.86 CI95% 1.06-7.66) and the presence of associated comorbidities (OR 1.59, CI95% 0.98-2.57).

Conclusions

Treatment adherence has been suboptimal. The use of injectable drugs was associated with nonadherence to treatment. No adherence predictors associated with the patient, disease and health system were found.

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