Medication beliefs in first-line and second-line treated multiple sclerosis patients

• Published in: Multiple sclerosis and related disorders 2020-07, Vol.42, p.102144, Article 102144
• Main Authors: Pust, Gesa Elena Albertine, Untiedt, Benthe, Weierstall-Pust, Roland, Randerath, Jennifer, Barabasch, Anna, Rahn, Anne Christin, Heesen, Christoph
• Format: Article
• Language: English
• Subjects: Adherence Behaviour; Adult; Female; First-line treated patients; Health Knowledge, Attitudes, Practice; Humans; Immunologic Factors - adverse effects; Immunologic Factors - classification; Immunologic Factors - therapeutic use; Male; Medication Adherence - statistics & numerical data; Middle Aged; Multiple Sclerosis; Multiple Sclerosis - drug therapy; Second-line treated patients
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2020.102144

•Treatments differ between pwMS treated with firstline compared to secondline medication.•Necessity beliefs and also concerns beliefs were significantly higher in second-line treated pwMS.•Higher disability was associated with higher necessity and concerns belief.•Illness beliefs did not significantly differ between firstline compared to secondline treated pwMS. Background: Immune treatments of multiple sclerosis (MS) can be classified in first-line and second-line approaches. While in both treatment efficacy is often not easy to assess in the short-term, treatment and illness beliefs may differ in first-line and second-line treated patients. The current study aimed to assess differential beliefs about medicine and illness perception between these groups based on the hypothesis that they are closely connected to adherence behaviour. Methods: An online survey through the website of the German MS Society was performed investigating beliefs about immune treatments as well as the patients’ illness perceptions with validated questionnaires. Demographic factors, disability and self-reported adherence rates were studied as moderator variables. Results: In total, 630 patients participated. Data of 433 first-line treated and 192 second-line treated patients with MS (PwMS) were analysed. Necessity beliefs and also concerns beliefs were significantly higher in second-line treated PwMS (MANCOVA p =.001 and p =.006) and generally in patients with higher disability, while illness perception did not differ between groups. Self-assessed adherence rates were around 70% for oral treatments and injectables irrespective of first-line or second-line. Nonadherence was below 5% for infusion treatments. However, most patients reported only single omissions. Conclusion: The current study reveals differential behavioural attitudes between first-line versus second-line-treated PwMS. However, follow-up studies are needed to further unravel the relationship between behavioural attitudes and treatment adherence.