Case Study: Improving Medication Adherence in MS Patients With Cognitive Deficits

Woman exercising boy's hand
Woman exercising boy’s hand
Poor medication timing, incorrect doses, medication disorganization, and under- or over-medication are some of the medication adherence issues that can occur in patients with MS and cognitive symptoms.
The following article is part of live conference coverage from the 2018 ACTRIMS Forum in San Diego, California. 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 ACTRIMS 2018.

Researchers are conducting a case study highlighting strategies and methodology that occupational therapists can use to address medication management in patients with multiple sclerosis (MS) who experience cognitive symptoms and deficits. Results will be presented at the 2018 ACTRIMS Forum in San Diego, California.

“Medication management is an important instrumental activity of daily living skill that occupational therapists address in clinical treatment, and is an important functional daily activity, particularly for those living with MS,” wrote Ashley Uyeshiro Simon, OTD, OTR/L, MSCS, and Rebecca Cunningham, OTD, OTR/L, from the University of Southern California. 

“Poor medication timing, incorrect doses, medication disorganization, and under- or over-medication are some of the problems that can result due to cognitive deficits, and that have the potential to influence the patient’s treatment plan and long-term course of disease.”

Occupational therapists can use the following interventions to improve the ability of a person with MS and cognitive deficits to engage in medication management: compensatory cognitive strategies, safety assessment, adaptive equipment assessment and training, schedule development, environmental cues, and organization skill development.

“The descriptive case study will highlight the use of compensatory cognitive strategies, environmental cues, organization skill development, time management tools, and adaptive equipment-based interventions with an individual living with MS who demonstrated cognitive deficits that challenged the ability to adhere to a medication regimen,” the researchers wrote.

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Outcome measures include the Canadian Occupational Performance Measure, Multiple Sclerosis Quality of Life Inventory, RAND Short Form-36, and the Montreal Cognitive Assessment.

The researchers have collected pre-intervention outcome measures in the case study patient, and after discharge from occupational therapist services, post-intervention measures will be collected and presented at the conference. The benefits of interventions by occupational therapists to improve adherence to a medication regimen will also be demonstrated.

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Akhbardeh A, Arjona J, Gourraud P-A, Graves JS. Wearable multi-sensor device captures limb dysfunction and MS progression. Presented at: ACTRIMS Forum 2018; February 1-3, 2018; San Diego, CA. Poster 231.