Adherence to immunomodulatory drugs in multiple sclerosis: Evaluation of discontinuation reasons [Aderência à Terapêutica Imunomoduladora na Esclerose Múltipla: Avaliação dos motivos de interrupção]

• Type: Another Publication in an International Scientific Journal
• Date: 2006

Authors

Castro, S (Author) Other; Joana Guimaraes (Author) FMUP; Carinha, P (Author) Other; Rio, ME (Author) Other; Reis, J (Author) Other; Pereira, S (Author) Other; Sa, MJ (Author) Other

Journal

Title: Sinapse

Vol. 6

Pages: 36-40

ISSN: 1645-281X

Publisher: Sociedade Portuguesa de Neurologia

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-007-FQY

Abstract (EN): Introduction: Evaluation of therapeutic adherence can be hard to assess in chronic diseases, such as Multiple Sclerosis (MS), in outpatients clinic environment. Knowledge of the reasons that lead MS patients to discontinue medicines is of the utmost importance to allow early intervention of the health professional to avoid it. Objective: Evaluation of adherence to immunomodulatory drugs in MS patients. Description and introspection over reasons for discontinuating therapy. Material and methods: We retrospectively reviewed for 2004, the file implemented in Unidade de Farmácia do Ambulatório. From the 324 MS patients (224 women; 100 men; median age: 40.5 ± 11.3 years) under treatment with immunomodulatory drugs that year (Avonex® - 97; Betaferon® - 93; Copaxone® - 30; Rebif22® - 67; Rebif44® - 37), we found 85 cases with monthly gaps on drug pick up. These patients were interviewed by phone to determine the factors related to drug adherence: start and discontinuation dates and reasons. Results: From the 85 interviewed patients, drug discontinuation was confirmed to occur by their own will in 15 patients (4.6%), after an average duration of treatment of 37.1 months with the following drugs: Avonex® - 4; Betaferon® - 3; Copaxone® - 3; Rebif22® - 0; Rebif44® - 5. These patients evidenced several reasons to stop treatment: adverse reactions (6), personal convenience (4), self-perception of inefficacy (3), feeling of "no need" (1) and "tiredness of needles" (1). This small sample didn't allow establishing a causal relationship between reason and drug. In 9 patients (60%), discontinuation has been temporary (average: 3.8 months; range: 1-10 months). Discussion: Discontinuation rate found in this study is lower than in similar studies, which can be interpreted as good adherence from our MS patients to immunomodulatory treatment. Our MS Outpatient Clinic Care Unit organization, in which a team of different health professionals work together, favouring personal contact of MS patients with the health team in an open setting whenever they need, may explain our results. Nevertheless, it should be possible to prevent some reasons for drug discontinuation.

Language: Portuguese

Type (Professor's evaluation): Scientific