Assessing Barriers to Adherence with the Use of Dimethyl Fumarate in Multiple Sclerosis

Background Multiple sclerosis (MS) is a chronic, inflammatory, central nervous system demyelinating disease that requires long-term use of disease-modifying therapies (DMT). Patient adherence to DMT is key in reducing the inflammation that leads to relapses and neurodegeneration. Dimethyl fumarate (...

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Bibliographic Details
Published in:Clinical drug investigation 2020, Vol.40 (1), p.73-81
Main Authors: Aungst, Angela, Casady, Lise, Dixon, Crystal, Maldonado, Janice, Moreo, Natalie, Pearsall, Laurie, Robertson, Derrick
Format: Article
Language:English
Subjects:
Activities of daily living
Chronic illnesses
Clinical medicine
Drug dosages
Electronic monitoring
Emotional disorders
Internal Medicine
Medicine
Medicine & Public Health
Mood disorders
Multiple sclerosis
Nervous system
Neurodegeneration
Patient compliance
Pharmacology/Toxicology
Pharmacotherapy
Quality of life
Questionnaires
Short Communication
Social support
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Summary:Background Multiple sclerosis (MS) is a chronic, inflammatory, central nervous system demyelinating disease that requires long-term use of disease-modifying therapies (DMT). Patient adherence to DMT is key in reducing the inflammation that leads to relapses and neurodegeneration. Dimethyl fumarate (DMF) poses unique challenges to adherence including being the only twice-daily dosing DMT. Previous research suggests there are direct roles that providers play on improving their patients’ adherence rates, such as focusing on the patient-provider relationship, helping put the patient at ease so that they feel understood and respected. Also, route of administration affects adherence in other chronic healthcare conditions. However, the issue of adherence to DMT in MS is more complex than just route of administration, with adverse effects being the main predictor of adherence. Objectives (1) To define various patient specific factors (e.g. fatigue and mood disorders) that affect adherence with DMF and (2) to understand how patients’ perceptions of treatment satisfaction (such as effectiveness, convenience, side effects and global satisfaction) and DMFs impact on quality of life (such as social support, activities of daily living, coping) influence adherence. Methods Our study was a prospective, observational measurement of adherence to treatment with DMF in MS patients over 52 weeks. Twenty-five out of thirty-five patients enrolled completed the study. Adverse event (AE) data was reviewed on all participants. Results Adherence rates correlated with patient’s perceived effectiveness (0.25, p  
ISSN:1173-2563
1179-1918
DOI:10.1007/s40261-019-00866-6