Treatment Adherence Improving Among MS Patients? Study Finds Mixed Results

It appears that patients with multiple sclerosis are better at sticking to prescribed therapies, according to a population study recently published in Multiple Sclerosis and Related Disorders. The study was conducted by Charity Evans, PhD, BSP, of the University of Saskatchewan in Canada, and colleagues.

The researchers say their aim was to “estimate the prevalence and predictors of optimal adherence and persistence to the disease modifying therapies (DMT) for multiple sclerosis (MS) in 3 Canadian provinces.” In order to reach that aim, they used health services databases from British Columbia, Saskatchewan, and Manitoba to access information about patients who received prescriptions for a DMT between January 1996 through December 31, 2011 (British Columbia), March 31, 2014 (Saskatchewan), and March 31, 2012 (Manitoba). Natalizumab and oral therapies were not included. There was a total of 4830 subjects included.

“In this population-based cohort study, optimal adherence was observed in 76% of subjects after one year of therapy,” report the researchers. There were some differences between provinces, and the researchers note, “those subjects who initiated therapy in recent years were more likely to have suboptimal adherence and to discontinue their DMT within the first 12 months than those who started treatment in earlier years.”

The findings are both supported and contradicted by previous studies, and the researchers say they “did not identify any specific characteristics associated with adherence.” The go on to add “These findings highlight the challenges in identifying individuals that may be at risk for poor adherence or persistence to the DMTs for MS.”

Even though almost one-quarter of the participants had suboptimal adherence, the researchers say, “we observed a higher proportion of optimal adherence than previously reported in the MS literature.” Previous studies had some differences compared to this one: they were conducted in the US and included commercially insured subjects. The authors of the present study say, “These observed differences may reflect the differences in healthcare systems.”

The increased likelihood of discontinuation of DMTs in more recent years, the authors say could be “a reflection of greater choice and drug access.” There are more DMTs available, so switching is an option that did not exist earlier.

Although there are limitations to this study, the researchers conclude “closer examination as to why adherence appears to be better in MS, and how adherence influences disease outcomes will not only help increase our understanding of the disease, but may also prove useful in advancing the management of other chronic diseases.”