Background: Despite the apparent benefits of disease-modifying drug (DMD) use among multiple sclerosis (MS) patients, their rates of adherence are often variable and in some cases are quite low. Aim of the study: To assess medication adherence and its relationship with treatment satisfaction of MS patients in Saudi Arabia Patients and methods: Following a cross-sectional design, 598 adult MS patients were recruited from all tertiary care hospitals in all regions of Saudi Arabia. Patients' medication adherence was assessed using the Arabic version of the eight-item Morisky Medication Adherence Scale (MMAS-8). Treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication. Disease severity was assessed using the Patient-Determined Disease Steps (PDDS). Results: The most used drug was interferon beta-1b (24.1%), while 18.7% were using interferon beta-1a and 17.4% were using fingolimod. Patients' mean PDDS was 2.8 ± 1.9. Only 9.7% were "adherent" to medication. Patients' adherence differed according to their educational level (p < 0.001), their currently received medications (p = 0.032), with those on Fingolimod having the highest adherence (17.3%). Treatment satisfaction was significantly higher among adherent patients (p < 0.023). The main reasons for changing prescribed drugs were the presence of attacks, i.e., response to treatment was substandard (41.8%) and the experienced side effects of used drugs (39.9%). PDDS differed significantly according to patients' treatment adherence only among those receiving interferon beta-1b, with higher mean severity score among those who were adherent (p = 0.002). Conclusions: Medication adherence among MS patients in Saudi Arabia is low. Higher adherence is associated with patients' higher education. The main underlying reasons for changing prescribed drugs are the presence of attacks, substandard response to treatment, or suffering the DMDs' side effects. Medication adherence is associated with higher treatment satisfaction.

No abstract

Background: The arterial blood gas (ABG) parameters of patients admitted to intensive care units (ICUs) with acute neuromuscular respiratory failure (NMRF) and non-NMRF have not been defined or compared in the literature. Methods: We retrospectively collected the initial ABG parameters (pH, PaCO2, PaO2, and HCO3) of patients admitted to ICUs with acute respiratory failure. We compared ABG parameter ranges and the prevalence of abnormalities in NMRF versus non-NMRF and its categories, including primary pulmonary disease (PPD) (chronic obstructive pulmonary disease, asthma, and bronchiectasis), pneumonia, and pulmonary edema. Results: We included 287 patients (NMRF, n = 69; non-NMRF, n = 218). The difference between NMRF and non-NMRF included the median (interquartile range (IQR)) of pH (7.39 (7.32–7.43), 7.33 (7.22–7.39), p < 0.001), PaO2 (86.9 (71.4–123), 79.6 (64.6–99.1) mmHg, p = 0.02), and HCO3 (24.85 (22.9–27.8), 23.4 (19.4–26.8) mmol/L, p = 0.006). We found differences in the median of PaCO2 in NMRF (41.5 mmHg) versus PPD (63.3 mmHg), PaO2 in NMRF (86.9 mmHg) versus pneumonia (74.3 mmHg), and HCO3 in NMRF (24.8 mmol/L) versus pulmonary edema (20.9 mmol/L) (all p < 0.01). NMRF compared to non-NMRF patients had a lower frequency of hypercarbia (24.6% versus 39.9%) and hypoxia (33.8% versus 50.5%) (all p < 0.05). NMRF compared to PPD patients had lower frequency of combined hypoxia and hypercarbia (13.2% versus 37.8%) but more frequently isolated high bicarbonate (33.8% versus 8.9%) (all p < 0.001). Conclusions: The ranges of ABG changes in NMRF patients differed from those of non-NMRF patients, with a greater reduction in PaO2 in non-NMRF than in NMRF patients. Combined hypoxemia and hypercarbia were most frequent in PPD patients, whereas isolated high bicarbonate was most frequent in NMRF patients.

No abstract

No abstract