Non-compliance with disease modifying therapies in patients with Multiple Sclerosis: A qualitative analysis.

Multiple Sclerosis and Related Disorders
Karly StratosLiesly Lee

Abstract

Factors associated with adherence to disease modifying therapies (DMT) in patients with Multiple Sclerosis (MS) have been reported before, but little has been studied on compliance to a physician's initial treatment recommendations. The objective of this study was to assess the factors associated with compliance to physician recommended treatment in treatment-naïve patients with MS. We studied a cohort of patients with MS followed at an academic MS center in Toronto, Canada between January 2015 and May 2018. We used log-binomial models to identify patient-level factors (age, sex, and smoking history), and MS-specific clinical details (delay in diagnosis, and age at diagnosis) associated with compliance. Of the 332 patients, 256 (77.1%) were recommended DMT and 80 (31.3%) did not follow the recommendation. The most common causes for refusal to initiate DMT were: personal preference to not embark on a medication (46.2%), wishing to use a conservative approach (22.5%) or use of complementary medical approaches (18.8%). Twenty-one () patients who initially were compliant to treatment recommendations subsequently stopped DMT against medical advice. The two most common reasons for this nonadherence included adverse effects (61.8%) an...Continue Reading

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