Integrated Practice Model Can Improve Adherence to Multiple Sclerosis Therapies

This article was originally published on the Specialty Pharmacy Times website.

Use of an integrated approach to care can improve patient compliance with multiple sclerosis (MS) therapies, according to a pharmacy practice model published in the March 15, 2014, issue of the American Journal of Health-System Pharmacy.

Developed by a team of researchers at the University of Illinois Hospital and Health Sciences System (UI Health), the model seeks to address patient compliance with disease-modifying therapies (DMTs) that are used to treat MS, which are often costly and require special administration, handling, and storage. The treatment is also associated with a high rate of nonadherence and additional safety risks.

“Management of DMTs can be challenging because of the specialized training and monitoring requirements, the debilitating nature of MS, and the high rates of patient nonadherence,” the authors write. “Some authors have reported that nonadherence rates are notably higher with DMTs compared with other long-term medications.”

Various studies have placed DMT adherence rates among patients with MS at anywhere from 41% to 88%.

“Poor adherence may be attributable to a lack of observable effect on symptoms, the severity of the disease, insufficient knowledge about the disease, insufficient social support, unrealistic expectations regarding therapy benefits, the need for frequent and lifelong injections, a fear of injections, and troublesome adverse effects,” the authors note.

Beyond the challenge of adherence, health care providers must also coordinate with multiple entities outside the health system, which places a time burden on staff resulting in inconsistencies with electronic medical record documentation, delayed initiation of treatment, and increased turnaround time for training, according to the authors. To address these challenges, UI Health developed an interdisciplinary practice that involves doctors, a registered nurse, and a clinical pharmacist.

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