Depression, Fatigue Predict Adherence to Multiple Sclerosis Therapies

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The investigators categorized adherence based on MMAS scores, including high, moderate, and low adherence scores.
The investigators categorized adherence based on MMAS scores, including high, moderate, and low adherence scores.
The following article is part of conference coverage from the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Nashville, Tennesssee. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2018.

According to study findings presented at the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 30-June 2 in Nashville, Tennessee, depression and fatigue may predict the risk for suboptimal adherence to disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS). Comparatively, patients with MS who are male and slightly older may have higher adherence to these therapies.

“Suboptimal medication adherence adversely impacts treatment efficacy and outcomes,” wrote the study authors. “Factors predicting patient adherence behavior may impact the selection of therapeutic approach for the treatment of MS, including the choice of escalation or induction paradigms.”

A total of 499 patients with MS were included in the retrospective, observational, cross-sectional analysis. Investigators reviewed patient-reported outcomes recorded during clinical care (Beck Depression Inventory [BDI], Modified Fatigue Impact Scale [MFIS], and Morisky Medication Adherence Scale [MMAS-8]), as well as standardized validated computerized cognitive testing (NeuroTrax) and the Expanded Disability Status Scale (EDSS) to analyze predictive factors for poor or high medication adherence rates.

Additional predictive factors included in the analysis included age, gender, marital status, employment, driving capability, and number of previous DMTs prescribed/taken. The investigators categorized adherence based on MMAS scores, including high (MMAS-8 score = 0), moderate (MMAS-8 score = 1-2), and low (MMAS-8 score = 3-8) adherence scores.

High adherence to DMTs was reported in 114 patients (41.8%), according to the MMAS. Medium and low adherence to DMTs was reported in 82 (30.0%) and 77 (28.2%) patients, respectively. Demographic factors associated with high MMAS-8 adherence scores included older age (P =.0139) and male gender (P =.0231). Patients with higher rates of depression (P =.0282) and fatigue (P =.0222) were significantly more likely to have lower MMAS-8 adherence scores. No other associations were found.

“Lower adherence to DMTs was associated with higher depression and fatigue, whereas higher adherence was associated with older age and male gender,” the investigators concluded. “Patient-centric factors related to adherence behavior may impact efficacy and disease-associated costs and should be considered and incorporated in the decision process of prescribing MS DMTs.”

Disclosure: This study was supported by Sanofi.

For more coverage of CMSC 2018, click here.

Reference

Carattini T, Bacque E, Wisseman K, et al.  Decision factors relating to prescribing disease modifying therapies: prediction of adherence behavior in patients with multiple sclerosis. Presented at: 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers. May 30-June 2, 2018; Nashville, TN. Abstract DX01.

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