Multiple modality approach to assess adherence to medications across time in Multiple Sclerosis

Neter, Efrat; Wolkowitz, Anat; Glass-Marmor, Lea; Lavi, Idit; Ratzabi, Sharonne; Leibkovitz, Izabella; Miller, David H.

doi:10.1016/j.msard.2020.101951

Cited by 9 publications

(14 citation statements)

References 29 publications

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“…Adherence to DMTs in this sample of PwMS, assessed by the combination of measures, medication claims and patients' reports [27], fell within the range reported in previous studies on medication adherence [2,24]. The novel finding of the present study is that adherence and persistence were consistently associated prospectively with patient-related factors, specifically perceptions of medicationbeliefs on the harm medication cause, their overuse and general concern.…”

Section: Discussionsupporting

confidence: 80%

“…For categorical variables, counts and percentages are provided whereas means and standard deviations (SDs) are presented for continuous variables. Adherence was constructed so that non-adherence was defined as either detected/reported by one of the PRO or MPR [27]; it is presented across Time 1 and Time 2, and also by DMT administration route. Persistence is reported as staying with the same medication between baseline and Time 2, and reasons for discontinuation are described.…”

Section: Discussionmentioning

confidence: 99%

“…An adherence score was constructed so that good adherence was defined as either = > 80% medication claims per regimen (medication possession ratio (MPR)), or = > 80% self-reported medication use by MS-TAQ, or being at the medium-high and high categories of ProMAS. Full details are described in a methodological report [27]. Low adherence was defined as the complement to good adherence.…”

Section: Adherence and Persistencementioning

confidence: 99%

“…Only few studies in MS [18,[26][27][28] have used multiple measures of adherence and longitudinally examined their association with varied potential antecedents. Thus, the present study aimed at assessing both adherence and persistence using multiple measures (patient reported outcomes and medication claims) and examined their association with diverse predictors among MS patients (Fig.…”

Section: Introductionmentioning

confidence: 99%

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Beliefs about medication as predictors of medication adherence in a prospective cohort study among persons with multiple sclerosis

et al. 2021

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Background Though adherence to disease-modifying therapies (DMTs) among persons with multiple sclerosis (PwMS) varies and is often below 80%, only few prospective studies on adherence examined predictors beyond demographic and clinical characteristics. Objectives Identify antecedents to adherence and persistence to DMT in a prospective design among PwMS. Methods PwMS (n = 186) were prospectively assessed at three time points: baseline, 6 (Time 1) and 12 months later (Time 2). Clinical, demographic information and patient-reported medication beliefs, illness perceptions, medication habits, perceived health and affect were surveyed in-person. Adherence and persistence were assessed by a combination of self-reports and retrospective review of medication claims. Findings PwMS were 69.9% (Time 1) and 71% (Time 2) adherent to their DMTs and 64.5.9% were persistent. Beliefs about Medications were consistently predictive at both time points (baseline to Time 1 and Time 1 to Time 2) of medication adherence and persistence whereas other perceptions were predictive in some analyses; clinical and demographic characteristics were mostly not predictive of adherence nor persistence. The prospective association of beliefs about medication with adherence held also in multivariate analyses (OR = 0.88, 95% CI 0.78–0.99, p = 0.029). Conclusions Adherence and persistence are predicted by medication beliefs of PwMS. As medication beliefs are modifiable, they should be assessed periodically and targeted as a focus of tailored interventions aimed to improve adherence and consequently health outcomes in PwMS. Registration Clinical trials registry #NCT02488343, date: 06/08/2015.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Adherence and Persistencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beliefs about medication as predictors of medication adherence in a prospective cohort study among persons with multiple sclerosis

et al. 2021

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“…These findings imply that adherence may be over-estimated by retrospective self-report, as suggested by previous studies. 8,16,26,27 Possible explanations may be that patients do not remember accurately the number of missed doses, or that their report is more representative of the most recent time period, whereas adherence may change over time. It is also possible that patients are reluctant to admit non-adherence to avoid a rebuke by the care team.…”

Section: Discussionmentioning

confidence: 99%

Mobile phone-based e-diary for assessment and enhancement of medications adherence among patients with multiple sclerosis

Golan

Sagiv

Glass-Marmor³

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Adherence to multiple sclerosis (MS) disease-modifying drugs (DMDs) is essential for realization of their optimal effectiveness and benefits. Objective To evaluate the usefulness and validity of a smartphone-based e-diary as a tool for adherence assessment as well as its effectiveness as a promoter of adherence to DMDs. Methods An MS tailored e-diary (MyMS&Me) reminded patients to take their DMDs on time. DMD intake was self-recorded in the e-diary by the participants. Three methods of adherence evaluation were compared: e-diary derived, retrospective self-reported, and the medication possession rate (MPR). The proportion of patients with poor adherence to DMDs (defined as MPR <80%) among e-diary users was compared with a control group without intervention. Results Sixty-two patients downloaded the e-diary (Female: 41 (66%), Expanded Disability Status Scale 3.2 ± 2.2) and 55 controls were enrolled. The median difference between e-diary-derived adherence and the MPR was –3% (95% limits of agreement: −53% to 12%). The median difference between retrospective self-reported adherence and the MPR was 0.3% (95% limits of agreement: −20% to 42%). The proportion of participants with poor adherence to DMDs was similar in the e-diary and control groups (10% vs. 13%, p = 0.6). Conclusions Substantial and clinically important disagreement between methods of medication adherence evaluation was noted. Smartphone reminders did not significantly improve the MPR of DMDs.

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Medication habits among persons with multiple sclerosis

Neter

Glass-Marmor²,

Wolkowitz³

et al. 2022

Multiple Sclerosis and Related Disorders

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Multiple modality approach to assess adherence to medications across time in Multiple Sclerosis

Cited by 9 publications

References 29 publications

Beliefs about medication as predictors of medication adherence in a prospective cohort study among persons with multiple sclerosis

Beliefs about medication as predictors of medication adherence in a prospective cohort study among persons with multiple sclerosis

Mobile phone-based e-diary for assessment and enhancement of medications adherence among patients with multiple sclerosis

Medication habits among persons with multiple sclerosis

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